Individual
JONATHAN M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 W 4TH ST, ODESSA, TX 79761-5001
(432) 640-2401
(432) 640-4606
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-2401
(432) 640-4606
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136197
TX
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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