Davis, Grace Violet
Davis, Grace Violet is an sole proprietor health care provider with primary practice located at 203 W Kelly St , Sylvester GA 31791-2021. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Davis, Grace Violet can be contacted via phone (229) 777-0488.Contact Information
Primary practice address
203 W Kelly St
Sylvester GA 31791-2021
Phone: (229) 777-0488
Fax: (229) 777-0476
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 039770 | Georgia |
Profile Details
| NPI number | 1679534945 |
|---|---|
| LBN Legal business name | Davis, Grace Violet |
| Credentials | M.D., M.P.H. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2006 |
| Last updated | Jul 10th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679534945 | NPPES |
| Georgia | MEDICAID | 000654475K |
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