Individual
CONOR LEE DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
Mailing address
200 MULLINS DR, LEBANON, OR 97355-3983
(541) 259-0235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PG225495
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/02/2023
Last updated
05/28/2025
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