Individual
CHARLES EUGENE DAVIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
272 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 877-2850
(606) 877-2857
Mailing address
272 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 877-2850
(606) 877-2857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100246460
—
KY
Enumeration date
06/05/2013
Last updated
09/05/2013
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