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Individual

MR. WILLIAM DAVENPORT III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSFA

Contact information

Practice address
2605 GAULT AVE N, FORT PAYNE, AL 35967-3751
(256) 979-1550
Mailing address
64 GINGER LAKE DRIVE, ROCK SPRING, GA 30739-2249
(423) 321-2506

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
154845
GA

Other

Enumeration date
11/22/2014
Last updated
11/19/2018
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