| Davis Family Medicine | |
|
223 Dallas Ave Selma AL 36701-5744 | |
| (334) 874-0017 | |
| (334) 872-6563 |
| Full Name | Davis Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 223 Dallas Ave, Selma, Alabama |
| Authorized Official Name and Position | Glenton W Davis (OWNER) |
| Authorized Official Contact | 3348740017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Family Medicine 223 Dallas Ave Selma AL 36701-5744 Ph: (334) 874-0017 | Davis Family Medicine 223 Dallas Ave Selma AL 36701-5744 Ph: (334) 874-0017 |
| NPI Number | 1427238997 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 12/01/2020 |
| Medicare PECOS PAC ID | 6305039843 |
|---|---|
| Medicare Enrollment ID | O20101018000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427238997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14309 (Alabama) | Primary |
| Provider Name | Glenton W Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962475046 PECOS PAC ID: 8123000213 Enrollment ID: I20170807000522 |
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