Provider Demographics
NPI:1710387691
Name:MR RIGHT REVEREND GREGORY KARL DAVIS
Entity Type:Organization
Organization Name:MR RIGHT REVEREND GREGORY KARL DAVIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BISHOP
Authorized Official - Prefix:MR
Authorized Official - First Name:RT REVEREND GREGORY
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-965-3974
Mailing Address - Street 1:1075 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 3650
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3912
Mailing Address - Country:US
Mailing Address - Phone:404-965-3974
Mailing Address - Fax:404-965-3874
Practice Address - Street 1:1075 PEACHTREE ST NE
Practice Address - Street 2:SUITE 3650
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3912
Practice Address - Country:US
Practice Address - Phone:404-965-3974
Practice Address - Fax:404-965-3874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable