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Organization
MICHAEL L DAVIS M.D., P.A.
Active
Organization
MICHAEL L DAVIS M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LEE DAVIS M.D. (M.D./PRESIDENT)
(601) 630-9755
Entity
Organization
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 630-9755
Mailing address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 630-9755
(601) 630-9120
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
08327
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09455302
—
MS
05
—
1319422
—
LA
Enumeration date
09/23/2008
Last updated
01/27/2009
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