Individual
MELISSA S DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2250 LEESTOWN RD, LEXINGTON, KY 40511-1052
(859) 233-4511
Mailing address
1157 TABORLAKE WALK, LEXINGTON, KY 40502-7719
(606) 571-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30210
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374866
BLUE CROSS AND BLUE SHIELD
—
01
—
000000578808
BLUE CROSS AND BLUE SHIELD
—
05
—
64095722
—
KY
Enumeration date
01/28/2006
Last updated
02/24/2022
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