Provider Demographics
NPI:1629180971
Name:HERRING, DAVEY DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVEY
Middle Name:DONALD
Last Name:HERRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-0389
Mailing Address - Country:US
Mailing Address - Phone:478-955-8326
Mailing Address - Fax:
Practice Address - Street 1:103 E GENERAL STEWART WAY STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2607
Practice Address - Country:US
Practice Address - Phone:229-468-0711
Practice Address - Fax:294-680-7142
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022369208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000235452OMedicaid
GA02BDBLDMedicare ID - Type Unspecified
GA000235452OMedicaid