Provider Demographics
NPI:1336249994
Name:DAVIS, ANNE B (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 NORTH ST E
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2529
Mailing Address - Country:US
Mailing Address - Phone:256-315-2252
Mailing Address - Fax:256-362-1664
Practice Address - Street 1:803 NORTH ST E
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160
Practice Address - Country:US
Practice Address - Phone:256-315-2252
Practice Address - Fax:256-362-1664
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25004207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009955145Medicaid
AL124997Medicaid
AL138825Medicaid
AL124997Medicaid
AL102I110063Medicare PIN
AL138825Medicaid