Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DN5660 | FL |
NPI | 1093769051 |
---|---|
Provider Name | Dr. James Aubrey Davis JR. |
First Address | Tallahassee, FL 32308 |
Second Address | Tallahassee, FL 32308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/12/2010 |