Individual
DR. MICHELLE LEE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
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
207R00000X
Internal Medicine Physician
Primary
36009
TN
208000000X
Pediatrics Physician
36009
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3379172
—
TN
Enumeration date
12/05/2006
Last updated
01/14/2010
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