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DR. HENRY GORDON DAVIS M.D.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1427189943
Individual Registrant:DR. HENRY GORDON DAVIS M.D.
Gender: M
Sole Proprietor
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
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
Tel: 229-776-2141 Fax: 229-776-9684
Registration Information:
NPI: 1427189943
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | 005124 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DRUG ENFORCEMENT ADMINIST | AD1182120 | GA | 01 |
