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Individual

DR. JONATHAN MICHAEL DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
240 N HIGHLAND AVE NE, UNIT 3312, ATLANTA, GA 30307-5609
(706) 513-0201
Mailing address
240 N HIGHLAND AVE NE, UNIT 3312, ATLANTA, GA 30307-5609
(706) 513-0201

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2007-00142
NC
207Q00000X
Family Medicine Physician
Primary
59630
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051230593D
GA
Enumeration date
02/18/2007
Last updated
01/09/2011
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