| Mr Leamon L Davenport, DO | |
|
30 Medical Center Blvd, Suite 205, Upland, PA 19013-3955 | |
| (610) 619-7410 | |
| (610) 876-8483 |
| Full Name | Mr Leamon L Davenport |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 30 Medical Center Blvd, Upland, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649230525 | NPI | - | NPPES |
| 43670083 | Medicaid | NM | |
| 807919 | Medicaid | AZ |
| Entity Name | Prospect Health Access Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568819084 PECOS PAC ID: 5698065142 Enrollment ID: O20160613000737 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Leamon L Davenport, DO 30 Medical Center Blvd, Suite 205, Upland, PA 19013-3955 Ph: (610) 619-7410 | Mr Leamon L Davenport, DO 30 Medical Center Blvd, Suite 205, Upland, PA 19013-3955 Ph: (610) 619-7410 |
Janisha Patel, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Medical Center Blvd, Crozer Pediatrics, Pob 1, Suite 205, Upland, PA 19013 Phone: 610-619-7410 Fax: 610-876-8483 | |
Rita P Nunag, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 30 Medical Center Blvd, Suite 205, Upland, PA 19013 Phone: 610-619-7410 Fax: 610-490-0925 | |
Dr. Blaze Robert Gusic, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30 Medical Center Blvd, Suite 205, Upland, PA 19013 Phone: 610-619-7410 Fax: 610-876-8483 | |
Erin E. Schnepp, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 30 Medical Center Blvd, Suite 205, Upland, PA 19013 Phone: 610-619-7410 Fax: 610-876-8483 |