Provider Demographics
NPI:1578754875
Name:DAVIS, JOSEPH BARTLETT (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BARTLETT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9600 BLACKWELL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:855-420-8517
Practice Address - Street 1:7350 SANDLAKE COMMONS BLVD
Practice Address - Street 2:MEDPLEX B, SUITE 2212A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:689-500-4016
Practice Address - Fax:689-500-4032
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255869207VE0102X
FLOS19325207VE0102X
WI60890207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY255869OtherNEW YORK STATE MEDICAL LICENSE
FLOS19325OtherFLORIDA STATE MEDICAL LICENSE
OH34.009667OtherSTATE OF OHIO