Provider Demographics
NPI:1982813853
Name:DAVIS, WELLINGTON JOSEPH III (MD)
Entity Type:Individual
Prefix:DR
First Name:WELLINGTON
Middle Name:JOSEPH
Last Name:DAVIS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1210 S CEDAR CREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6229
Practice Address - Country:US
Practice Address - Phone:610-402-7999
Practice Address - Fax:610-402-7995
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2019-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-1093542086S0122X
PAMD4320652086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery