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1003935453
JERRY M. DAVENPORT
NOME, AK
NPI
1003935453
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: AK 4105)
Enumeration Date
2007-03-28
Last Update Date
2011-01-26
Business Address
Dr. JERRY M. DAVENPORT D. O.
306 W 5TH AVE NORTON SOUND HEALTH COOPERATION
NOME, AK 99762
Phone number: 907-443-3214
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Mailing Address
Dr. JERRY M. DAVENPORT D. O.
9223 STONE RIDGE CIR
SANDY, UT 84093-2698
Phone number: 801-944-1335
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