Provider Demographics
NPI:1548727613
Name:DAVIS, GEORGE SCOTT II (MS, RDN, CDN)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:SCOTT
Last Name:DAVIS
Suffix:II
Gender:M
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BRISTOL CIR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:NY
Mailing Address - Zip Code:12775-6002
Mailing Address - Country:US
Mailing Address - Phone:845-800-5013
Mailing Address - Fax:
Practice Address - Street 1:20 BRISTOL CIR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:NY
Practice Address - Zip Code:12775-6002
Practice Address - Country:US
Practice Address - Phone:845-800-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered