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General NPI Number Information
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NPI Number | 1619235033
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Entity Type | Individual
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Provider Name | SARA MADISON DAVENPORT MOSCOW MD
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1700 NICHOLASVILLE RD STE 704
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City | LEXINGTON
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State | KY
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Zip | 40503-1467
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Country | US
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Telephone | 859-278-0363
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Fax | 859-278-0363
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Provider Business Mailing Address
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Address Line | 1908 TRUETT AVE
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City | NASHVILLE
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State | TN
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Zip | 37206-1844
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Country | US
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Telephone | 919-522-7658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 59421
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101256921
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 54673
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License Number State | KY
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