Individual
GRACE VIOLET DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
203 W KELLY ST, SYLVESTER, GA 31791-2021
(229) 777-0488
(229) 777-0476
Mailing address
203 W KELLY ST, P.O. BOX 5367, SYLVESTER, GA 31791-2021
(229) 777-0488
(229) 777-0476
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
039770
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000654475K
—
GA
Enumeration date
03/28/2006
Last updated
07/10/2008
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