Organization
WOMENS HEALTH OF BLAIRSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVINS S DAVIS MD (OWNER)
(706) 745-9220
Entity
Organization
Contact information
Practice address
47 WEAVER RD, SUITE A, BLAIRSVILLE, GA 30512-3136
(706) 745-9220
Mailing address
PO BOX 1145, BLAIRSVILLE, GA 30514-1145
(706) 745-9220
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
45765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000936108C
—
GA
01
—
GRP4349
MEDICARE GROUP NUMBER
—
Enumeration date
06/13/2006
Last updated
01/18/2008
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