Individual
JOHNATHAN O'NEIL DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 MEDICAL CENTER DR, HAZARD, KY 41701
(606) 439-6779
(606) 487-8448
Mailing address
200 MEDICAL CENTER DR, HAZARD, KY 41701-9466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2393
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100551170
—
KY
Enumeration date
08/13/2018
Last updated
05/16/2025
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