Organization
JAMES LEE DAVENPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LEE DAVENPORT M.D. (OWNER)
(423) 542-4189
Entity
Organization
Contact information
Practice address
306 PINE HILL RD, ELIZABETHTON, TN 37643-2920
(423) 542-4189
(423) 542-4181
Mailing address
306 PINE HILL RD, ELIZABETHTON, TN 37643-2920
(423) 542-4189
(423) 542-4181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34068
TN
207R00000X
Internal Medicine Physician
36009
TN
208000000X
Pediatrics Physician
36009
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3379172
—
TN
Enumeration date
04/04/2007
Last updated
01/14/2010
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