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GRACE VIOLET DAVIS M.D., M.P.H.
>> Pediatrics >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1679534945
Individual Registrant: GRACE VIOLET DAVIS M.D., M.P.H.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
203 W KELLY ST SYLVESTER, GA 31791-2021 US
Tel: 229-777-0488 Fax: 229-777-0476
Tel: 229-777-0488 Fax: 229-777-0476
Contact information for business:
203 W KELLY ST P.O. BOX 5367 SYLVESTER, GA 31791-2021 US
Tel: 229-777-0488 Fax: 229-777-0476
Tel: 229-777-0488 Fax: 229-777-0476
Registration Information:
NPI: 1679534945
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | GA | 039770 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 000654475K | GA | 05 |
