Individual
LONNIE D DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1635 N GEORGE MASON DR STE 180, ARLINGTON, VA 22205-3633
(301) 530-1010
Mailing address
8230 BOONE BLVD STE 200, TYSONS CORNER, VA 22182-2647
(703) 848-0800
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101239878
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
541439176
TAX ID
VA
Enumeration date
06/16/2006
Last updated
04/13/2021
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