Davis, Gary M

Davis, Gary M is an individual health care provider with primary practice located at 5903 Ridgewood Rd Ste 340, Jackson MS 39211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Davis, Gary M can be contacted via phone (601) 899-3340.

Contact Information

Primary practice address
5903 Ridgewood Rd Ste 340 Jackson MS 39211
Phone: (601) 899-3340
Fax: (601) 899-3343
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 11174 Mississippi

Profile Details

NPI number 1912065251
LBN Legal business name Davis, Gary M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Jul 8th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912065251 NPPES
Mississippi MEDICAID 00115962

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