Organization
LANA J DAVENPORT MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA J DAVENPORT MD (OWNER)
(606) 547-4536
Entity
Organization
Contact information
Practice address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 547-4536
(866) 511-5587
Mailing address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 547-4536
(866) 511-5587
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
42000
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2863558
—
OH
05
—
7100050630
—
KY
Enumeration date
02/10/2010
Last updated
06/27/2011
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