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DR. HENRY GORDON DAVIS M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1427189943

Individual Registrant:
DR. HENRY GORDON DAVIS M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
108 E LIBERTY AVE  SYLVESTER, GA 31791-2162 US
Tel: 229-776-2141  Fax: 229-776-9684

Contact information for business:
PO BOX 405  SYLVESTER, GA 31791-0405 US
Tel: 229-776-2141  Fax: 229-776-9684

Registration Information:
NPI: 1427189943
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
GA005124

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DRUG ENFORCEMENT ADMINISTAD1182120GA01




HEALTH CARE JOBS GA - Page 1



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