Individual
DR. JERRY EUGENE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39000593A
IN
1041C0700X
Clinical Social Worker
Primary
34002606A
IN
106H00000X
Marriage & Family Therapist
35000571A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183652
ANTHEM BCBS
IN
01
—
7389148
AETNA
IN
Enumeration date
09/22/2006
Last updated
09/11/2025
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