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Individual

BARBARA DAVANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
143 FOLLINS LN, ST SIMONS ISLAND, GA 31522-4263
(912) 634-7714
(912) 634-7734
Mailing address
143 FOLLINS LN, ST SIMONS ISLAND, GA 31522-4263
(912) 634-7714
(912) 634-7734

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
50150
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00923139A
GA
Enumeration date
11/29/2007
Last updated
11/29/2007
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