Individual
KEVIN WESLEY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
775 POPLAR RD, SUITE 250, NEWNAN, GA 30265-8300
(770) 400-4610
(678) 423-2739
Mailing address
775 POPLAR RD, SUITE 250, NEWNAN, GA 30265-8300
(770) 400-4610
(678) 423-2739
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
064355
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
764840117A
—
GA
Enumeration date
09/23/2005
Last updated
11/01/2012
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