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Individual
MR. BARTLETT EMORY DAVIS
Active
Individual
MR. BARTLETT EMORY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT00981
GA
363A00000X
Physician Assistant
Primary
1574
GA
363A00000X
Physician Assistant
209883
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01075299
AMERIGROUP
GA
05
—
1740483
—
AK
05
—
450809077B
—
GA
05
—
450809077C
—
GA
Enumeration date
05/03/2007
Last updated
03/02/2026
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