Individual
MARCUS RYAN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
605 SILVERSTONE RD STE 100, LAFAYETTE, LA 70508
(337) 266-9985
Mailing address
605 SILVERSTONE RD STE 100, LAFAYETTE, LA 70508-6899
(972) 393-5559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
309327
LA
Other
Enumeration date
02/27/2017
Last updated
07/22/2019
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