Davis, Takeisha Charles

Davis, Takeisha Charles is an sole proprietor health care provider with primary practice located at 1434 Tiger Dr , Thibodaux LA 70301-4337. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Davis, Takeisha Charles can be contacted via phone (985) 447-0916.

Contact Information

Primary practice address
1434 Tiger Dr Thibodaux LA 70301-4337
Phone: (985) 447-0916
Fax: (985) 447-0920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD200311 Louisiana

Profile Details

NPI number 1427048404
LBN Legal business name Davis, Takeisha Charles
Credentials MD, MPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Aug 5th, 2014 - about 10 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 1427048404 NPPES
Louisiana MEDICAID 64663

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