Organization
DAVIS PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANITIA W35500263550021 DAVIS DPM (OWNER)
(601) 355-0026
Entity
Organization
Contact information
Practice address
128 POINDEXTER ST, JACKSON, MS 39203-3048
(601) 355-0026
(601) 355-0069
Mailing address
128 POINDEXTER ST, JACKSON, MS 39203-3048
(601) 355-0026
(601) 355-0069
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
80207
MS
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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