Individual
DR. JEFFERSON JOHN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
48352
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258493000
—
MN
Enumeration date
02/14/2006
Last updated
05/20/2016
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