Individual
JARED MICHAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1019 ROSEMARY DR, LOUISVILLE, KY 40213-1119
(601) 874-1162
Mailing address
1019 ROSEMARY DR, LOUISVILLE, KY 40213-1119
(601) 874-1162
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R2448
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100177660
—
KY
Enumeration date
04/08/2010
Last updated
03/02/2015
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