Mr Charles Seth Davis, CRNP | |
19250 N Mobile St, Citronelle, AL 36522-2122 | |
(251) 866-7454 | |
(251) 866-9121 |
Full Name | Mr Charles Seth Davis |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Primary Care |
Location | 19250 N Mobile St, Citronelle, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699194522 | NPI | - | NPPES |
011846 | Other | AL | MEDICARE GROUP PAYEE NUMBER |
1063439065 | Other | AL | NPI GROUP PAYEE NUMBER |
630000013 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | 1-091410 (Alabama) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 1-091410 (Alabama) | Primary |
Entity Name | Childrens Urgent Care, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124541438 PECOS PAC ID: 9234405408 Enrollment ID: O20171017000804 |
Entity Name | Mobile County Board Of Health |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063439065 PECOS PAC ID: 9931208386 Enrollment ID: O20180913000728 |
Mailing Address | Practice Location Address |
---|---|
Mr Charles Seth Davis, CRNP 251 N Bayou St, Mobile, AL 36603-5827 Ph: (251) 690-8158 | Mr Charles Seth Davis, CRNP 19250 N Mobile St, Citronelle, AL 36522-2122 Ph: (251) 866-7454 |
Thaila Keodouangdy, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-9126 | |
Mrs. Latanja Shanta Batain, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-7454 Fax: 251-544-2188 | |
Ms. Hillary Macall Whitfield, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 | |
Nancy Ursprung, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-7454 Fax: 251-866-9121 |