# RICHARD D DAVENPORT MD AND ASSOCIATES, SC

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

## Provider details

- **NPI number:** 1699710434
- **Authorized official:** RICHARD DRAKE DAVENPORT MD (PRESIDENT)
- **Authorized official phone:** (414) 328-8762

## Contact information

- **Practice address:** 3033 W LAYTON AVE STE 101, GREENFIELD, WI 53221-2628
- **Practice address phone:** (414) 279-5579
- **Practice address fax:** (414) 249-3299
- **Mailing address:** 3033 W LAYTON AVE STE 101, GREENFIELD, WI 53221-2628
- **Mailing address phone:** (414) 279-5579
- **Mailing address fax:** (414) 249-3299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 19876 | WI | — |
| 207W00000X | Ophthalmology Physician | — | WI | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 12/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 21300200 | — | WI |
| 01 | — | CC8272 | PALMETTO GBA-RAILROAD | WI |