Individual
KELLY SHEA DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
307 BOATNER RD STE 112, EGLIN AFB, FL 32542-1302
(850) 883-9394
Mailing address
307 BOATNER RD STE 112, EGLIN AFB, FL 32542-1302
(850) 883-9394
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME155854
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/08/2016
Last updated
04/05/2022
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