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Leslie Erin Davis, PA

Physician Assistant in Vicksburg, MS. Individual provider (NPI-1).

NPI number1053977249
StatusActive
Last updated in NPPESDec 18, 2023

Details

NPI
1053977249
Entity type
Individual (NPI-1)
Name
Leslie Erin Davis
Credential
PA
Sex
Female
Sole proprietor
No
Enumeration date
May 14, 2019
Certification date
Dec 18, 2023
Last updated
Dec 18, 2023

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - PHYSICIAN ASSISTANT
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA00426MSYes

Practice location

1202 Mission Park Dr
Vicksburg, MS 39180-3758

Phone 601-738-5549

Mailing address

1202 Mission Park Dr
Vicksburg, MS 39180-3758

Phone 601-738-5549

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant providers in Vicksburg, MS

All 13 Physician Assistant providers in Vicksburg · All 1,002 providers in Vicksburg

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