Davis, Clifton H

Davis, Clifton H is an individual health care provider with primary practice located at 3688 Veterans Memorial Dr Suite 200, Hattiesburg MS 39401-8246. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Davis, Clifton H can be contacted via phone (601) 554-7400.

Contact Information

Primary practice address
3688 Veterans Memorial Dr Suite 200 Hattiesburg MS 39401-8246
Phone: (601) 554-7400
Fax: (601) 554-7488
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA021 Mississippi

Profile Details

NPI number 1083647960
LBN Legal business name Davis, Clifton H
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Dec 23rd, 2009 - about 17 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 1083647960 NPPES
Mississippi MEDICAID 01802226

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