| Doctor Name: | MR. CHARLES SETH DAVIS |
| NPI Number: | 1699194522 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CRNP |
| License Number: | 1-091410 |
| Business Practice Address: | 19250 N Mobile St Citronelle, AL - 365222122 |
| Business Phone Number: | 2518667454 |
| Business Fax Number: | 2518669121 |
| Mailing Address: | 251 N Bayou St, MOBILE |
| State: | AL |
| Postal Code: | 366035827 |
| Phone Number: | 2516908158 |
| Fax Number: | 2515442188 |
| NPI Enumeration Date: | 04/08/2014 |
| NPI Last Update Date: | 04/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 1-091410 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |