Provider Demographics
NPI:1043029002
Name:DAVISON, TORRIS JAMARCUS (CPR, BLS)
Entity type:Individual
Prefix:
First Name:TORRIS
Middle Name:JAMARCUS
Last Name:DAVISON
Suffix:
Gender:M
Credentials:CPR, BLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4433
Mailing Address - Country:US
Mailing Address - Phone:470-624-8098
Mailing Address - Fax:
Practice Address - Street 1:1325 S PARK ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4433
Practice Address - Country:US
Practice Address - Phone:470-624-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059767985343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)