Individual
DAVIS L MELLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-9957
(706) 721-7718
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-9957
(706) 721-7718
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5965
GA
Other
Enumeration date
09/28/2010
Last updated
02/09/2022
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