Provider Demographics
NPI:1154565950
Name:DAVISON, LAKESHA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:LAKESHA
Middle Name:MARIE
Last Name:DAVISON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:404-296-7211
Practice Address - Street 1:2240 FOUNTAIN DR
Practice Address - Street 2:KAISER PERMANENTE SNELLVILLE MEDICAL CENTER
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2919
Practice Address - Country:US
Practice Address - Phone:404-296-7133
Practice Address - Fax:404-296-7211
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2022-01-10
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Provider Licenses
StateLicense IDTaxonomies
GA003953208000000X
GA67290208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics