Individual
JONATHAN A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
072564
GA
207R00000X
Internal Medicine Physician
Primary
85095
SC
208000000X
Pediatrics Physician
072564
GA
208000000X
Pediatrics Physician
85095
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151477C
—
GA
05
—
003151477D
—
GA
Enumeration date
05/27/2010
Last updated
01/05/2021
Update your record
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