Individual
AMANDA SUE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 GORDON GUTMANN BLVD, SUITE 201, JEFFERSONVILLE, IN 47130-3764
(812) 282-6114
(812) 280-2142
Mailing address
301 GORDON GUTMANN BLVD STE 201, JEFFERSONVILLE, IN 47130-3766
(812) 282-6114
(812) 650-5313
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
47103
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01076341A
MD LICENSURE
IN
01
—
47103
KY MEDICAL LICENSE NUMBER
KY
Enumeration date
06/03/2010
Last updated
05/23/2019
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