Organization
ORBIE TROY DAVIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA DEYOUNG (CREDENTIALING MANAGER)
(502) 245-0767
Entity
Organization
Contact information
Practice address
13100 MAGISTERIAL DR, SUITE 100, LOUISVILLE, KY 40223-4102
(502) 245-0767
(502) 245-1380
Mailing address
13100 MAGISTERIAL DR, SUITE 100, LOUISVILLE, KY 40223-4102
(502) 245-0767
(502) 245-1380
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
007078
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6936
MEDICARE PROVIDER NUMBER
GA
Enumeration date
09/14/2007
Last updated
10/29/2009
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