NPI age
19 years
Enumerated 2007-05-03
● Active
Type 1 · Individual
MR. Bartlett Emory Davis, PAC ATC
Davis is 1 of 14 physician assistant providers in Vidalia and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA, AK
2 states
Status
Active
No deactivations on record
Last NPPES update
2026-03-02
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
19 years
↑ 11 yr above median (8 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 24% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Practice location
1707 Meadows Ln, Suite H
Vidalia, GA 304747200
Mailing address
Po Box 1793
Vidalia, GA 304751793
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
10 Doctors St
Metter, GA 304393337
Location 3
12 Doctors St
Metter, GA 30439
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
-
Specialist/TechnologistAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 01075299 | AMERIGROUP |
| 05 (AK) | 1740483 | |
| 05 (GA) | 450809077B | |
| 05 (GA) | 450809077C |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.