Individual
MR. GLENTON W DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
223 DALLAS AVE, SELMA, AL 36701-5744
(334) 874-0017
(334) 872-6563
Mailing address
223 DALLAS AVE, SELMA, AL 36701-5744
(334) 874-0017
(334) 872-6563
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14309
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051550426
—
AL
Enumeration date
02/09/2006
Last updated
12/01/2020
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