Individual
CARLETON B DAVIS
Active
Individual
CARLETON B DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20909
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007150
PHYSICIANS PLUS
—
01
—
10858
MEDICAID DEAN
—
01
—
11800226
MEDICARE PART B
—
01
—
30126700
HIRSP
—
05
—
30126700
—
WI
01
—
39080850938
UNITY
—
01
—
90002361
WEA INS
—
Enumeration date
09/13/2006
Last updated
07/08/2007
Update your record
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