Individual
ERIC G DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 E GRAY ST STE 900, LOUISVILLE, KY 40202-3905
(502) 569-2220
(502) 584-6851
Mailing address
PO BOX 60677, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
40623
KY
208600000X
Surgery Physician
40623
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200859990
MEDICAID PASSPORT
IN
01
—
50014590
MEDICAID PASSPORT
KY
05
—
64130503
—
KY
Enumeration date
12/26/2006
Last updated
03/03/2026
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