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Organization

RICHARD D DAVENPORT MD AND ASSOCIATES, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD DRAKE DAVENPORT MD (PRESIDENT)
(414) 328-8762
Entity
Organization

Contact information

Practice address
3033 W LAYTON AVE STE 101, GREENFIELD, WI 53221-2628
(414) 279-5579
(414) 249-3299
Mailing address
3033 W LAYTON AVE STE 101, GREENFIELD, WI 53221-2628
(414) 279-5579
(414) 249-3299

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
19876
WI
207W00000X
Ophthalmology Physician
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21300200
WI
01
CC8272
PALMETTO GBA-RAILROAD
WI
Enumeration date
06/17/2006
Last updated
12/09/2022
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