Provider Demographics
NPI:1760583918
Name:DAVIDSON, JOHN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 319
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4111
Mailing Address - Country:US
Mailing Address - Phone:404-355-4100
Mailing Address - Fax:404-355-7500
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 319
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4111
Practice Address - Country:US
Practice Address - Phone:404-355-4100
Practice Address - Fax:404-355-7500
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA012155207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00067955AMedicaid
GA109515OtherBCBS
GA109515OtherBCBS