Individual
CHANTY DENISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
165 EMERY HWY, SUITE 100, MACON, GA 31217-3666
(478) 741-2150
(478) 741-2208
Mailing address
165 EMERY HWY, SUITE 100, MACON, GA 31217-3666
(478) 741-2150
(478) 741-2208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
050097
GA
207RN0300X
Nephrology Physician
Primary
050097
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000911039C
—
GA
05
—
000911039D
—
GA
05
—
000911039E
—
GA
01
—
CJ4042
RAILROAD MEDICARE GROUP
GA
01
—
P00408060
RAILROAD MEDICARE
GA
Enumeration date
07/26/2006
Last updated
10/13/2022
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