Individual
DAVID DEVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
672 W. 400 S., SUITE 101, SPRINGVILLE, UT 84663
(801) 491-9883
(801) 489-3141
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
290516-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D3263
—
UT
Enumeration date
07/17/2006
Last updated
11/02/2023
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