MEDICARE: DR. JAMES ALEXANDER DAVENPORT MD

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	207V00000X	Obstetrics & Gynecology Physician	ME25681	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760435002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ALEXANDER DAVENPORT MD

Provider Business Mailing Address
First Line	:	PO BOX 14266
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-4266
Country	:	US
Telephone Number	:	850-656-1997
Fax Number	:	850-656-1936

Provider Business Practice Location Address
First Line	:	2418 E PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5301
Country	:	US
Telephone Number	:	850-656-1997
Fax Number	:	850-656-1936

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	02/02/2010

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