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Individual

DR. JEFFREY CRAIG DAVENPORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3815 S BOULEVARD, EDMOND, OK 73013-5479
(405) 285-7568
(405) 285-7634
Mailing address
3815 S BOULEVARD, EDMOND, OK 73013-5479
(405) 285-7568
(405) 285-7634

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24933
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200089300A
OK
Enumeration date
07/06/2006
Last updated
03/27/2019
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