Individual
JAY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 AVENUE F, BOGALUSA, LA 70427-3634
(985) 730-7001
(985) 730-7006
Mailing address
1542 TULANE AVE, LSUHSC DEPT OF OBGYN, NEW ORLEANS, LA 70112-2865
(504) 568-4890
(504) 568-6496
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
322466
LA
207VM0101X
Maternal & Fetal Medicine Physician
322466
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
322466
STATE LICENSE
LA
Enumeration date
04/04/2013
Last updated
07/01/2021
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