Healthcare Provider Details

I. General information

NPI: 1215321450
Provider Name (Legal Business Name): BRANDI RAE DAVIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRANDI RAE ROBINSON MD

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SPRING HILL AVE SUITE 3414
MOBILE AL
36604-1414
US

IV. Provider business mailing address

1600 SPRING HILL AVE SUITE 3414
MOBILE AL
36604-1414
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3475
  • Fax:
Mailing address:
  • Phone: 251-434-3475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number81377
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: