Healthcare Provider Details

I. General information

NPI: 1528689296
Provider Name (Legal Business Name): GABRIELLA REGINA EDINGTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 DR MARTIN L KING JR AVE
MOBILE AL
36603-5341
US

IV. Provider business mailing address

PO BOX 485
LINCOLN AL
35096-0485
US

V. Phone/Fax

Practice location:
  • Phone: 251-432-4117
  • Fax: 251-436-7762
Mailing address:
  • Phone: 850-559-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberTRN30355
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.46380
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: