Organization
OMEGA PHYSICIAN PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH DAVIS MD MPH (ANESTHESIOLOGIST)
(205) 317-8437
Entity
Organization
Contact information
Practice address
1300 RIDENOUR BLVD NW, KENNESAW, GA 30152-4501
(770) 702-1806
Mailing address
3927 CONCORD WALK DR SE, SMYRNA, GA 30082-3659
(205) 317-8437
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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