Individual
MICHAEL L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 630-9755
Mailing address
PO BOX 820328, VICKSBURG, MS 39182-0328
(601) 630-9755
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
08327
MS
207RN0300X
Nephrology Physician
10165R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116318
—
MS
05
—
1319422
—
LA
Enumeration date
06/28/2006
Last updated
01/28/2009
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