# DAVENPORT ADULT CARE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174737621
- **Authorized official:** KATHY C DAVENPORT ARNP (OWNER)
- **Authorized official phone:** (918) 423-3400

## Contact information

- **Practice address:** 1609 N STRONG BLVD, SUITE 300, MCALESTER, OK 74501-1146
- **Practice address phone:** (918) 423-3400
- **Practice address fax:** (918) 420-5051
- **Mailing address:** 1609 N STRONG BLVD, SUITE 300, MCALESTER, OK 74501-1146
- **Mailing address phone:** (918) 423-3400
- **Mailing address fax:** (918) 420-5051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 20290 | OK | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 08/22/2020