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Individual

DR. JOHN THOMAS DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
510 LINCOLN DRIVE, HERRIN, IL 62948
(618) 997-6800
(618) 997-1187
Mailing address
510 LINCOLN DRIVE, HERRIN, IL 62948
(618) 997-6800
(618) 997-1187

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036-115943
IL
207X00000X
Orthopaedic Surgery Physician
Primary
036115943
IL

Other

Enumeration date
07/26/2006
Last updated
05/21/2015
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