Davenport, Richard D
Davenport, Richard D is an individual health care provider with primary practice located at 2424 S 90Th St Ste 506, West Allis WI 53227-2455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Davenport, Richard D can be contacted via phone (414) 328-8760.Contact Information
Primary practice address
2424 S 90Th St Ste 506
West Allis WI 53227-2455
Phone: (414) 328-8760
Fax: (414) 328-8763
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 19876 | Wisconsin |
Profile Details
| NPI number | 1811999063 |
|---|---|
| LBN Legal business name | Davenport, Richard D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Dec 3rd, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811999063 | NPPES |
| Wisconsin | Other | 18197019 | PALMETTO GBA-RAILROAD |
| Wisconsin | MEDICAID | 30939300 | PALMETTO GBA-RAILROAD |
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