Individual
BARRY ISAAC DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 N 1ST ST BLDG 46, ALTUS, OK 73523-5004
(580) 481-5230
Mailing address
301 N 1ST ST BLDG 46, ALTUS, OK 73523-5004
(580) 481-5230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
S9125
TX
207Q00000X
Family Medicine Physician
S9125
TX
2083A0100X
Aerospace Medicine Physician
Primary
37355
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201029430A
—
OK
01
—
37355
LICENSE
OK
Enumeration date
03/29/2019
Last updated
01/12/2026
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