Davis, Kevin Wesley

Davis, Kevin Wesley is an individual health care provider with primary practice located at 775 Poplar Rd Suite 250, Newnan GA 30265-8300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Davis, Kevin Wesley can be contacted via phone (770) 400-4610.

Contact Information

Primary practice address
775 Poplar Rd Suite 250 Newnan GA 30265-8300
Phone: (770) 400-4610
Fax: (678) 423-2739
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 064355 Georgia

Profile Details

NPI number 1194711283
LBN Legal business name Davis, Kevin Wesley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Nov 1st, 2012 - about 14 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 1194711283 NPPES
Georgia MEDICAID 764840117A

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