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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 1811999063 NPPES
Wisconsin Other 18197019 PALMETTO GBA-RAILROAD
Wisconsin MEDICAID 30939300 PALMETTO GBA-RAILROAD

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