Davis, Stacy C.
Davis, Stacy C. is an sole proprietor health care provider with primary practice located at 1450 Winter St , Augusta GA 30904-4708. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Davis, Stacy C. can be contacted via phone (706) 364-3371.Contact Information
Primary practice address
1450 Winter St
Augusta GA 30904-4708
Phone: (706) 364-3371
Fax: (706) 364-3380
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 043030 | Georgia |
Profile Details
| NPI number | 1386746378 |
|---|---|
| LBN Legal business name | Davis, Stacy C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Nov 1st, 2023 - about 2 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 | 1386746378 | NPPES |
| Georgia | MEDICAID | 000742948E |
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