# DAVIS PODIATRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912273814
- **Authorized official:** DR. STANITIA W35500263550021 DAVIS DPM (OWNER)
- **Authorized official phone:** (601) 355-0026

## Contact information

- **Practice address:** 128 POINDEXTER ST, JACKSON, MS 39203-3048
- **Practice address phone:** (601) 355-0026
- **Practice address fax:** (601) 355-0069
- **Mailing address:** 128 POINDEXTER ST, JACKSON, MS 39203-3048
- **Mailing address phone:** (601) 355-0026
- **Mailing address fax:** (601) 355-0069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 80207 | MS | Yes |

## Other

- **Enumeration date:** 03/26/2012
- **Last updated:** 03/26/2012