Individual
MR. CHARLES SETH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
19250 N MOBILE ST, CITRONELLE, AL 36522-2122
(251) 866-7454
(251) 866-9121
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
1-091410
AL
363LP2300X
Primary Care Nurse Practitioner
Primary
1-091410
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
—
1063439065
NPI GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
04/08/2014
Last updated
05/09/2025
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