# STATESVILLE HMA MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DAVIS MEDICAL GROUP OBSTETRICS & GYNECOLOGY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275069858
- **Authorized official:** MRS. JENNIFER JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 555 KITCHINGS DR, STATESVILLE, NC 28677-3576
- **Practice address phone:** (704) 872-7294
- **Practice address fax:** (704) 872-4078
- **Mailing address:** 4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
- **Mailing address phone:** (615) 465-7230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 28478 | NC | Yes |

## Other

- **Enumeration date:** 05/03/2017
- **Last updated:** 01/14/2022