Individual
EDWARD WATTS DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1431 W 10TH ST STE 5, LAUREL, MS 39440-2626
(601) 649-1437
(601) 649-1431
Mailing address
PO BOX 648, 1431 WEST 10TH STREET SUITE 5, LAUREL, MS 39441-0648
(601) 649-1437
(601) 649-1431
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
415
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880157
—
MS
Enumeration date
08/04/2006
Last updated
09/24/2012
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