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Individual

DEMETRIA LEONARD DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6100 PRIMACY PKWY, SUITE 112, MEMPHIS, TN 38119-0705
(901) 682-5335
(901) 682-5440
Mailing address
6100 PRIMACY PKWY, SUITE 112, MEMPHIS, TN 38119-0705
(901) 682-5335
(901) 682-5440

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1876
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1522983
TN
Enumeration date
07/21/2005
Last updated
08/16/2011
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