Individual
COLIN DEANE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 E VERMONT ST STE 110, INDIANAPOLIS, IN 46202-3685
(317) 559-0950
(317) 936-3028
Mailing address
PO BOX 586, GALLOWAY, OH 43119-0586
(317) 559-0950
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
71016312A
IN
363L00000X
Nurse Practitioner
Primary
71016312A
IN
Other
Enumeration date
09/29/2023
Last updated
07/20/2026
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