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DAVID WAYNE DAVIS

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1134609704

Individual Registrant:
 DAVID WAYNE DAVIS 
Gender: M
Sole Proprietor

Location and contact information for practice:
211 RANCHERA ST. NW  LIVE OAK, FL 32064-8463 US
Tel: 386-364-1751  Fax: 386-364-1761

Contact information for business:
23343 NW COUNTY ROAD 236  HIGH SPRINGS, FL 32643-9669 US
Tel: 386-365-0809  Fax: --

Registration Information:
NPI: 1134609704
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
FL9384698

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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