Provider Demographics
NPI:1316957319
Name:DAVIS, RITA-KAY MABINE (MD)
Entity type:Individual
Prefix:DR
First Name:RITA-KAY
Middle Name:MABINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2723
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-2723
Mailing Address - Country:US
Mailing Address - Phone:252-210-9856
Mailing Address - Fax:252-212-3497
Practice Address - Street 1:300 N GRACE ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5345
Practice Address - Country:US
Practice Address - Phone:252-210-9856
Practice Address - Fax:252-822-5067
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003006472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89136GFMedicaid
NCNCK870D851Medicare PIN