NPI 1003935453

Jerry M. Davenport, DO

Practitioner Family Medicine Physician Nome, AK

Practice location

Address: 306 W 5th Ave Norton Sound Health Cooperation, Nome, AK 99762
Phone: (907) 443-3214
Mailing address: 9223 Stone Ridge Cir, Sandy, UT 84093-2698

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 4105 (AK)

Other Family Medicine providers in Alaska →

Registry record

NPI: 1003935453
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Mar 2007
Record last updated: 26 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.