Individual
GARY M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5903 RIDGEWOOD RD, STE 340, JACKSON, MS 39211
(601) 899-3340
(601) 899-3343
Mailing address
PO BOX 2057, RIDGELAND, MS 39158
(601) 899-3340
(601) 899-3343
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
11174
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115962
—
MS
Enumeration date
12/05/2006
Last updated
07/08/2007
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