# MARION BERT DAVIS JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1881660827
- **Gender:** Man
- **Credential:** OD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC1401 | FL | Yes |

## Other

- **Enumeration date:** 02/28/2006
- **Last updated:** 01/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078126600 | — | FL |
| 01 | — | 19031 | BC/BS | FL |
| 01 | — | 410016448 | RAILROAD MEDICARE | FL |
| 01 | — | K6143 | PC-ACE PRO 32 | FL |