Most Relevant Information
Provider Data
| NPI Number: | 1003039975 |
| Provider Name: | JEROME ALFRED DAVIS M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 60-100430 |
Most Important Dates
| Enumeration Date: | 04/10/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
101 BROAD ST
PLATTSBURGH
NY
129012637
Practice Location Phone/Fax
| Phone: | 5185642187 |
| Fax: | 5185642188 |
Provider Mailing Location
52 COOPER DR
PLATTSBURGH
NY
129015302
Provider Mailing Phone/Fax
| Phone: | 5185614791 |
| Fax: | 5185642188 |