| Doctor Name: | DR. CAROLYN DAVIS |
| NPI Number: | 1598909178 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 050010 |
| Business Practice Address: | 36468 Emerald Coast Pkwy Suite 8102, Old South Centre Destin, FL - 325414799 |
| Business Phone Number: | 8506509500 |
| Business Fax Number: | |
| Mailing Address: | 913 Mar Walt Dr, FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325476647 |
| Phone Number: | 8502438229 |
| Fax Number: | 8508632540 |
| NPI Enumeration Date: | 04/27/2009 |
| NPI Last Update Date: | 04/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 050010 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |