Individual
MARK ROGERS DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 E MAIN ST, MORRISTOWN, TN 37814-6632
(423) 581-5984
(423) 581-0984
Mailing address
PO BOX 1718, MORRISTOWN, TN 37816-1718
(423) 581-5987
(423) 581-0984
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD0000026233
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3089699
—
TN
Enumeration date
08/15/2005
Last updated
03/05/2013
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