Individual
JACOB DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-3000
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TP350
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2019
Last updated
05/22/2025
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