Individual
JACLYN LEIGH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3658
Mailing address
1333 SAINT JULIEN ST, CHARLOTTE, NC 28205-5119
(618) 806-9342
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
164438
NC
Other
Enumeration date
04/13/2010
Last updated
03/08/2013
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