Individual
JAKE JOYNER DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 522-1800
(864) 522-1806
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
82819
SC
2085R0202X
Diagnostic Radiology Physician
82819
SC
2085R0202X
Diagnostic Radiology Physician
ME126785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017435000
—
FL
05
—
828199
—
SC
Enumeration date
06/09/2010
Last updated
12/07/2022
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