Provider Demographics
NPI:1164435806
Name:DAVENPORT, MARGARET KATHERINE (DO)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KATHERINE
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LEIGHTON AVENUE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207
Mailing Address - Country:US
Mailing Address - Phone:256-238-0200
Mailing Address - Fax:256-236-8007
Practice Address - Street 1:901 LEIGHTON AVENUE
Practice Address - Street 2:SUITE 506
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207
Practice Address - Country:US
Practice Address - Phone:256-238-0200
Practice Address - Fax:256-236-8007
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO326207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F41952Medicare UPIN