Individual
BENNETT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9321
(407) 947-1369
Mailing address
514 N FILLMORE ST APT 3, CORINTH, MS 38834-4879
(407) 947-1369
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-4137
MS
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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