Individual
CORY STEPHEN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 773-2332
Mailing address
7259 S BINGHAM JUNCTION BLVD, MIDVALE, UT 84047-4860
(866) 615-5536
(866) 588-4301
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10807
AZ
363AS0400X
Surgical Physician Assistant
55215
CA
Other
Enumeration date
09/03/2008
Last updated
02/06/2025
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