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Individual

CATHERINE D DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA/AA

Contact information

Practice address
624 BELLGROVE PT, MACON, GA 31220-7621
(478) 731-4009
Mailing address
624 BELLGROVE PT, MACON, GA 31220-7621
(478) 731-4009

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
002988
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100000477C
GA
05
100000477E
GA
05
100000477F
GA
05
100000477G
GA
01
391018
WELLCARE
GA
01
580628385
TRICARE
GA
01
P00097133
PALMETTO GBA
GA
01
P00422622
RAILROAD MEDICARE
GA
Enumeration date
03/08/2006
Last updated
12/10/2014
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