Male or Other

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)

Code

207R00000X

Primary Taxonomy

Yes

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

Provider Address

Other Internal Medicine Physician in Proctorville, Ohio:

Female

Taslima Mahmood M.D.

Proctorville, OH

Specialty: Internal Medicine Physician (Primary)