Provider Demographics
NPI:1902435167
Name:DAVIS, ALEXANDER GIRAUD (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:GIRAUD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 PRUDENTIAL DR STE 1900
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8373
Mailing Address - Country:US
Mailing Address - Phone:864-404-9681
Mailing Address - Fax:
Practice Address - Street 1:841 PRUDENTIAL DR STE 1900
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8373
Practice Address - Country:US
Practice Address - Phone:864-404-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME167787207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)