Individual
HARLEY JACOB DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4060 LONESOME RD, MANDEVILLE, LA 70448-7085
(985) 727-7701
(985) 727-7375
Mailing address
4060 LONESOME RD, MANDEVILLE, LA 70448-7085
(985) 727-7701
(985) 727-7375
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
336037
LA
Other
Enumeration date
06/06/2019
Last updated
06/28/2023
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