MEDICARE: DR. GEORGE WELDON DAVENPORT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor	517	NC

General Provider Information

NPI Number	:	1528172806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE WELDON DAVENPORT DC

Provider Business Mailing Address
First Line	:	PO BOX 204
Second Line	:
City	:	TRENTON
State	:	NC
Zip	:	28585-0204
Country	:	US
Telephone Number	:	252-448-3481
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 HWY 58N
Second Line	:
City	:	TRENTON
State	:	NC
Zip	:	28585
Country	:	US
Telephone Number	:	252-448-3481
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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