Individual
DR. PETER GLENN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 936-5682
(904) 346-0864
Mailing address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207-8209
(904) 396-5682
(904) 346-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME94594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274864900
—
FL
01
—
34092
BCBS
FL
05
—
869224359A
—
GA
Enumeration date
07/17/2006
Last updated
01/13/2023
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