Individual provider Active NPI

Davis Weidow, DO

  • Pulmonary Disease Physician
  • Mobile, AL
National Provider Identifier
1679100747
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DO.2721 Issued in AL
Practice address
2451 University Hospital Dr RM 714
Mobile, AL 36617-2300
Phone
(251) 471-7207
Fax
(251) 471-7468
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X DO.2721 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr RM 714
Mobile, AL 36617-2300

Mailing address

2451 University Hospital Dr BLDG 4TH
Mobile, AL 36617-2300
Phone (251) 471-7847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604001415 AL Practitioner - Internal Medicine 1153748868 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2721ALMDChiropractor
DO.2721ALMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gmuc of Citronelle LLC CurrentSince Apr 1, 2025 Accepting new patients
Greater Mobile Urgent Care CurrentSince Apr 1, 2025 Accepting new patients
Greater Mobile Urgent Care CurrentSince Apr 1, 2025 Accepting new patients
Gmuc of Saraland CurrentSince Apr 1, 2025 Accepting new patients
Gmuc of Springhill LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

19355 N 3rd St
Ste 104
Citronelle, AL 36522
Phone (251) 633-0123

2350 Schillinger Rd S
Ste A
Mobile, AL 36695
Phone (251) 633-0123

4402 Old Shell Rd
Mobile, AL 36608
Phone (251) 633-0123

1114 Shelton Beach Rd
Saraland, AL 36571
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575
Phone (251) 445-7618

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1679100747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR BLDG 4TH",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7847",
            "fax_number": "251-471-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR RM 714",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7207",
            "fax_number": "251-471-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDOW",
        "first_name": "DAVIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": "DO.2721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.