Glenn S. Davis M.D.
Internal Medicine Physician in Proctorville, OH(View on Map)
Full Name
Glenn Scott Davis M.D.
NPI Number
1124168406
NPI Type
Individual Provider
Gender
Male
Enumeration Date
02/07/2007
Specialties
(Taxonomies)Licenses
State
Ohio
License Number
350-72747
Contact
Information
Purpose
Mailing
Location
Address
90 JACKSON PIKE
98 STATE ST
City
Gallipolis
Proctorville
State
OH
OH
Postal Code
45631-1560
45669-8163
Country
US
US
Telephone Number
(740) 886-9370
(740) 886-9403
Identifiers
Identifier
1073272
000000189349
000000241476
110217004
2056840
3810012072
2056840
Identifier State
WV
OH
OH
Unknown
OH
WV
OH
Identifier Issuer
BWC
ANTHEM
OH MEDICAID - UNISON
RAILROAD MEDICARE
OH MEDICAID MOLINA
Unknown
Unknown
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
glenn.davis.1@17389.direct.athenahealth.com
Endpoint Description
Unknown
Use
Unknown
Content Type
Unknown
Affiliation
N
Endpoint Location
98 State StProctorville, OH456698163US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/21/2021