Individual
CARLETON B DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
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
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