Davis, Nicholas J

Davis, Nicholas J is an individual health care provider with primary practice located at 1008 Riverburch Pkwy , Dalton GA 30721-8630. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Davis, Nicholas J can be contacted via phone (706) 278-0518.

Contact Information

Primary practice address
1008 Riverburch Pkwy Dalton GA 30721-8630
Phone: (706) 278-0518
Fax: (706) 275-9715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT002251 Georgia

Profile Details

NPI number 1508898412
LBN Legal business name Davis, Nicholas J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Mar 29th, 2011 - 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 1508898412 NPPES
Georgia MEDICAID 384536109A
Georgia Other OPT002251

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