Individual
JESSICA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1459 LANEY WALKER BLVD, AE 3042, AUGUSTA, GA 30912
(706) 721-3466
Mailing address
1083 COLUMN WAY APT 205, FOREST, VA 24551-1888
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
10826
GA
208000000X
Pediatrics Physician
Primary
82287
SC
Other
Enumeration date
04/15/2019
Last updated
07/17/2022
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