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Individual

MR. JOSEPH BERTELL DAVIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.H.S.

Contact information

Practice address
2460 COLLEGE DRIVE, BATON ROUGE, LA 70808
(225) 239-5293
(225) 239-5439
Mailing address
2460 COLLEGE DRIVE, BATON ROUGE, LA 70808
(225) 239-5293
(225) 239-5439

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
601008607
LA
Enumeration date
01/02/2019
Last updated
05/17/2019
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