Provider Demographics
NPI:1255782751
Name:DAVIS, JOSEPHINE V (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:V
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:V
Other - Last Name:KERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2140 JUNCTION AVE
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-2358
Mailing Address - Country:US
Mailing Address - Phone:605-720-2600
Mailing Address - Fax:
Practice Address - Street 1:2140 JUNCTION AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-2358
Practice Address - Country:US
Practice Address - Phone:605-720-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-26
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine