Provider Demographics
NPI:1497813745
Name:DAVIS, JUSTIN CHESED KUTTNER (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:CHESED KUTTNER
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:322 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6550
Mailing Address - Country:US
Mailing Address - Phone:352-641-0123
Mailing Address - Fax:415-872-0560
Practice Address - Street 1:322 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6550
Practice Address - Country:US
Practice Address - Phone:352-641-0123
Practice Address - Fax:415-872-0560
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA91502207Q00000X
FLME88108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine