Individual
DR. MARK JOEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
141 COCONUT DR, INDIALANTIC, FL 32903-2607
(321) 610-8939
(321) 622-8728
Mailing address
141 COCONUT DR, INDIALANTIC, FL 32903-2607
(321) 610-8939
(321) 622-8728
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0065723
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250063900
—
FL
Enumeration date
08/15/2005
Last updated
08/10/2022
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