Provider Demographics
NPI:1063503175
Name:DAVIS, RICHARD DREW (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DREW
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:703 VOLKER HALL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-934-3795
Mailing Address - Fax:205-975-2499
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:LOWDER BLDG
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9790
Practice Address - Fax:205-638-9793
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL242042081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009949565Medicaid