Individual
EVAN WILLIAM DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1431 W 10TH ST, LAUREL, MS 39440-2626
(601) 649-1437
(601) 649-1431
Mailing address
1431 W 10TH ST, P O BOX 648, LAUREL, MS 39440-2626
(601) 649-1437
(601) 649-1431
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
820
MS
Other
Enumeration date
08/03/2010
Last updated
08/04/2010
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