Individual
DONICA J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1336 HWY 54 WEST BLDG 200, FAYETTEVILLE, GA 30214-3211
(770) 460-9777
Mailing address
1930 BRANNAN RD., MCDONOUGH, GA 30253
(678) 284-4686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1259
WI
363A00000X
Physician Assistant
Primary
7390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41924300
—
WI
Enumeration date
09/22/2005
Last updated
12/09/2019
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