Davis, Bartlett Emory

Davis, Bartlett Emory is an individual health care provider with primary practice located at 1707 Meadows Ln Suite H, Vidalia GA 30474-7200. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Davis, Bartlett Emory can be contacted via phone (912) 538-0040.

Contact Information

Primary practice address
1707 Meadows Ln Suite H Vidalia GA 30474-7200
Phone: (912) 538-0040
Fax: (912) 538-8133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT00981 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1574 Georgia

Profile Details

NPI number 1205058948
LBN Legal business name Davis, Bartlett Emory
Credentials PAC ATC
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated May 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205058948 NPPES
Georgia Other 01075299 AMERIGROUP
Georgia MEDICAID 450809077B AMERIGROUP
Georgia MEDICAID 450809077C AMERIGROUP

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