Davis, Jonathan Michael

Davis, Jonathan Michael is an individual health care provider with primary practice located at 1811 E Bert Kouns Industrial Loop Ste 210 , Shreveport LA 71105-5740. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Davis, Jonathan Michael can be contacted via phone (318) 212-3858.

Contact Information

Primary practice address
1811 E Bert Kouns Industrial Loop Ste 210 Shreveport LA 71105-5740
Phone: (318) 212-3858
Fax: (318) 212-3958
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 200400661 North Carolina
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 201971 Louisiana

Profile Details

NPI number 1801079330
LBN Legal business name Davis, Jonathan Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2007
Last updated Jul 6th, 2021 - about 4 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 1801079330 NPPES
Louisiana MEDICAID 1330612

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