Organization
A.C. DAVIS M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNA CHRISTINE DAVIS M.D. (PRESIDENT)
(985) 951-7882
Entity
Organization
Contact information
Practice address
69164 HIGHWAY 59, SUITE 1, MANDEVILLE, LA 70471-7782
(985) 951-7882
(985) 327-7873
Mailing address
PO BOX 386, MANDEVILLE, LA 70470-0386
(985) 951-7882
(985) 327-7873
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
013663
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1185116
—
LA
Enumeration date
10/02/2014
Last updated
10/02/2014
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