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Dereck Davis
NPI 1174567580 · on the registry since 2006
Practice
- Address
- 2600 N State St
Jackson, MS 39216 - Phone
- (601) 984-5220
- Fax
- (601) 984-5279
Registry record
- Primary taxonomy
- 208000000X
208000000X
- Also registered as
- 208000000X
- Licence states on file
- NC, MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-08-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi