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DAVID WAYNE DAVIS
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1134609704
Individual Registrant: DAVID WAYNE DAVIS
Gender: M
Sole Proprietor
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
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: --
Tel: 386-365-0809 Fax: --
Registration Information:
NPI: 1134609704
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | FL | 9384698 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
