Provider Demographics
NPI:1194813170
Name:DAVIS, GEORGE GREGORY (BS, DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GREGORY
Last Name:DAVIS
Suffix:
Gender:
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 NEWCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8452
Mailing Address - Country:US
Mailing Address - Phone:470-820-3970
Mailing Address - Fax:
Practice Address - Street 1:8136 KNOX BRIDGE HWY STE 3
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8522
Practice Address - Country:US
Practice Address - Phone:470-820-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU83650Medicare UPIN
GA35ZCHQVMedicare ID - Type Unspecified