Organization
GEORGIA DAVIS, M.D. AND ASSOCIATES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JOSEPH MERTZ (BUSINESS MANAGER)
(217) 787-9540
Entity
Organization
Contact information
Practice address
1331 BEDFORD DR, SUITE 101, MELBOURNE, FL 32940-1987
(321) 622-8114
(321) 622-4649
Mailing address
1112 RICKARD RD, SUITE B, SPRINGFIELD, IL 62704-1017
(217) 787-9540
(217) 787-9183
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0036078693
IL
Other
Enumeration date
12/16/2010
Last updated
07/26/2016
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