Davenport, Ken K

Davenport, Ken K is an individual health care provider with primary practice located at 900 Goodyear Avenue Suite B, Gadsden AL 35903-1108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Davenport, Ken K can be contacted via phone (256) 492-0020.

Contact Information

Primary practice address
900 Goodyear Avenue Suite B Gadsden AL 35903-1108
Phone: (256) 492-0020
Fax: (256) 492-0029
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 29230 Alabama

Profile Details

NPI number 1891976833
LBN Legal business name Davenport, Ken K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2007
Last updated Sep 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891976833 NPPES
Alabama MEDICAID 130499
Alabama Other 511-17039
Alabama Other D570
Alabama MEDICAID 529203130

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