Davenport Family Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DAVENPORT FAMILY MEDICAL CLINIC LLC

Practice address

101 W 6TH St
Deridder, LA 70634-4963

Phone

(337) 460-0690

Fax

(337) 460-0961

NPI assigned

Jul 23, 2009

Last updated

Jul 23, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Pearre Jones Davenport III, M.D.

Title

Owner

Phone

(337) 460-0690

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1063642114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 6TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344963",
            "telephone_number": "337-460-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 6TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344963",
            "telephone_number": "337-460-0690",
            "fax_number": "337-460-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT FAMILY MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "PEARRE",
        "authorized_official_middle_name": "JONES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-460-0690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Cressionnie, CSW, MSW
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• Daniel Daigle
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• Chequila Daniels
• David J. Brown, M.D. Apmc (DeRidder Sugical Clinic)
• David L. Jones, MD, LLC
• Dallas Day, PMHNP-BC
• Kati Dooley Day, APRN, CPNP-PC
• DDMS of Louisiana No 2, LLC

• Primary Care Clinic/Center in Deridder, LA
• Providers in Deridder, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.