Provider Demographics
NPI:1912189291
Name:DADAVIS LLC
Entity Type:Organization
Organization Name:DADAVIS LLC
Other - Org Name:D/B/A DUBLIN HYPERBARIC AND WOUND CONSULTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-237-7855
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-0766
Mailing Address - Country:US
Mailing Address - Phone:478-237-7855
Mailing Address - Fax:
Practice Address - Street 1:206 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2560
Practice Address - Country:US
Practice Address - Phone:478-237-7855
Practice Address - Fax:912-748-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH59989Medicare UPIN