Individual
MRS. STEPHANIE KIRBY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 N MAIN ST, ANDERSON, SC 29621
(864) 716-0063
(864) 716-0073
Mailing address
1501 N MAIN ST, ANDERSON, SC 29621-4734
(864) 716-0063
(864) 716-0073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006116
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003111148A
—
GA
Enumeration date
05/23/2011
Last updated
01/23/2019
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