Provider Demographics
NPI:1932160652
Name:DAVIS, JOHN D JR (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:321 MULBERRY ST SW
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5720
Mailing Address - Country:US
Mailing Address - Phone:828-757-5965
Mailing Address - Fax:828-757-5104
Practice Address - Street 1:8439 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:BLOWING ROCK
Practice Address - State:NC
Practice Address - Zip Code:28605-8957
Practice Address - Country:US
Practice Address - Phone:828-295-3116
Practice Address - Fax:828-295-4388
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-03-17
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Provider Licenses
StateLicense IDTaxonomies
NC23505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC27574OtherBCBS
NC8927574Medicaid
NC8927574Medicaid
NC27574OtherBCBS