Leo Davis, M.D.

Individual provider Active NPI Otolaryngology Physician · Dahlonega, GA

NPI 1376791244 · NPPES record last updated Sep 4, 2008

Key facts

NPI
1376791244
Entity type
Individual (NPI type 1)
Primary specialty
Otolaryngology Physician 207Y00000X
License
012310 (GA)
Practice address
70 Mountain Dr Ste C
Dahlonega, GA 30533-1629
Phone
(706) 867-0145
Fax
(706) 867-0148
NPI assigned
Sep 4, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4989TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Health Corporation of Dahlonega, Inc Past Accepting new patients
Allergy and ENT of Ga Past Accepting new patients
Georgia Heart Institute LLC Past
since Jan 8, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 012310 GA Yes

Addresses

Primary practice location

70 Mountain Dr Ste C
Dahlonega, GA 30533-1629

Mailing address

70 Mountain Dr Ste C
Dahlonega, GA 30533-1629
Phone (706) 867-0145

Other providers in Dahlonega, GA

All providers in Dahlonega, GA · Otolaryngology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.