| Doctor Name: | JAKE A DAVIS |
| NPI Number: | 1710380795 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 074782A |
| Business Practice Address: | 1610 W Townline St Creston, IA - 508011066 |
| Business Phone Number: | 6417823887 |
| Business Fax Number: | 6417823504 |
| Mailing Address: | 1700 W Townline St, CRESTON |
| State: | IA |
| Postal Code: | 508011054 |
| Phone Number: | 6417827091 |
| Fax Number: | 6417823830 |
| NPI Enumeration Date: | 10/03/2014 |
| NPI Last Update Date: | 10/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 074782A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |