Individual
CHARLES JORDAN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1824 N MAIN ST, HAZARD, KY 41701-1020
(606) 217-0920
(606) 217-0922
Mailing address
167 WOODLAND AVE, HAZARD, KY 41701-2060
(606) 217-0920
(859) 275-2130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2203DT
KY
Other
Enumeration date
10/22/2020
Last updated
09/15/2022
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