Individual
RICHARD D DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2424 S 90TH ST, STE 506, WEST ALLIS, WI 53227-2455
(414) 328-8760
(414) 328-8763
Mailing address
2424 S 90TH ST, STE 506, WEST ALLIS, WI 53227-2455
(414) 328-8760
(414) 328-8763
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19876
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18197019
PALMETTO GBA-RAILROAD
WI
05
—
30939300
—
WI
Enumeration date
06/01/2005
Last updated
12/03/2015
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