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Individual

DR. JERRY B DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264
Mailing address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01077544A
IN
207L00000X
Anesthesiology Physician
Primary
26729
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64267297
KY
Enumeration date
05/26/2006
Last updated
08/07/2024
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