Davis, Jerry A

Davis, Jerry A is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Davis, Jerry A can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 39878 Wisconsin
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 51338 Minnesota

Profile Details

NPI number 1760487573
LBN Legal business name Davis, Jerry A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Feb 10th, 2014 - about 11 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 1760487573 NPPES
Wisconsin MEDICAID 32521000

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