Davenport, Jake Joyner

Davenport, Jake Joyner is an individual health care provider with primary practice located at 1210 W Faris Rd , Greenville SC 29605-4444. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Davenport, Jake Joyner can be contacted via phone (864) 522-1800.

Contact Information

Primary practice address
1210 W Faris Rd Greenville SC 29605-4444
Phone: (864) 522-1800
Fax: (864) 522-1806
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME126785 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 82819 South Carolina
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 82819 South Carolina

Profile Details

NPI number 1407176712
LBN Legal business name Davenport, Jake Joyner
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2010
Last updated Dec 7th, 2022 - about 2 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 1407176712 NPPES
South Carolina MEDICAID 828199
South Carolina MEDICAID 017435000

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