Individual
DR. JACK DAVITT
Active
Individual
DR. JACK DAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C2-0024133
DE
207R00000X
Internal Medicine Physician
DO0000004725
TN
207R00000X
Internal Medicine Physician
T4142
TX
Other
Enumeration date
03/21/2019
Last updated
09/16/2022
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