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Ken Davenport

  • Male

Medical Specialty

Professional ID

  • NPI: 1891976833
  • PECOS ID: 8123297207
  • Enrollment ID: I20110805000433
  • Credential(MD, DO, DPM):
  • Medical School:
  • Medical School Graduation Year: 2011

Hospital Service

  • Hospital CCN1: 010040
  • Business Name (LBN)1: Gadsden Regional Medical Center
  • Hospital CCN2: 010046
  • Business Name (LBN)2: Riverview Regional Medical Center
  • Hospital CCN3: 010104
  • Business Name (LBN)3: Grandview Medical Center

Medical Practices

  • Organization Name: Surgical Associates Of Gadsden Pc
  • Group Practice ID assigned by PECOS: 3274598693
  • Number of Group Practice member: 2

Location

  • Address1: 900 Goodyear Ave
  • Address2: Suite B
  • City: Gadsden
  • State: Alabama
  • Zip Code: 35903
  • Phone Number: (256)492-0020

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):