Individual
TERRY LEE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BARRET AVE, SUITE 104, LOUISVILLE, KY 40204-1747
(502) 589-9310
(502) 583-5560
Mailing address
801 BARRET AVE, SUITE 104, LOUISVILLE, KY 40204-1747
(502) 589-9310
(502) 583-5560
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13892
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13892
STATE LICENSE
KY
Enumeration date
08/27/2006
Last updated
07/08/2007
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