Individual
DR. TAKEISHA CHARLES DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1434 TIGER DR, THIBODAUX, LA 70301-4337
(985) 447-0916
(985) 447-0920
Mailing address
1434 TIGER DR, THIBODAUX, LA 70301-4337
(985) 447-0916
(985) 447-0920
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD200311
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64663
—
LA
Enumeration date
10/21/2005
Last updated
08/05/2014
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