Individual
GLENN SCOTT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
98 STATE ST, PROCTORVILLE, OH 45669-8163
(740) 886-9403
(740) 446-5153
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 886-9370
(740) 446-5153
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
350-72747
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189349
ANTHEM
OH
01
—
000000241476
OH MEDICAID - UNISON
OH
01
—
1073272
BWC
WV
01
—
110217004
RAILROAD MEDICARE
—
01
—
2056840
OH MEDICAID MOLINA
OH
05
—
2056840
—
OH
05
—
3810012072
—
WV
Enumeration date
02/07/2007
Last updated
01/21/2021
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