Individual
DR. JAMES E DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3411 N WOODFORD ST, DECATUR, IL 62526-2861
(217) 877-0312
(217) 877-0397
Mailing address
3411 N WOODFORD ST, DECATUR, IL 62526-2861
(217) 877-0312
(217) 877-0397
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007432
IL
152W00000X
Optometrist
18002009B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007432
—
IL
01
—
18002009B
OPTOMETRY LICENSE
IN
Enumeration date
05/11/2006
Last updated
03/07/2023
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