Individual
JUSTIN R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-2429
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2195
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04-35493
KS
208000000X
Pediatrics Physician
2012004798
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
23806
MS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
44055
OK
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
R4957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02683804
—
MS
Enumeration date
05/10/2007
Last updated
01/20/2025
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