Individual
JUDY L DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
807 GLENDALE BLVD, VALPARAISO, IN 46384-2023
(219) 531-1999
(219) 465-7569
Mailing address
PO BOX 2023, 807 GLENDALE BLVD, VALPARAISO, IN 46384-2023
(219) 531-1999
(219) 465-7569
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
02001245
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090726
BCBS
IN
Enumeration date
12/19/2005
Last updated
07/08/2007
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