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Individual

PAUL A DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
380 HOSPITAL DRIVE, SUIE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
P O BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
GAR47450
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000556465G
GA
05
000556465H
GA
05
000556465I
GA
01
329384
WELLCARE
GA
01
430005363
RAILROAD MEDICARE
GA
05
43ZCBDP08
GA
Enumeration date
08/10/2006
Last updated
06/04/2013
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