Individual provider · Type 1 NPI

Spencer Lance Davenport, PA-C

Medical Physician Assistant · Ogden, UT

NPI number 1649553835 Active

Practice location

4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5929015-8906 (UT)

Medical Physician Assistant: Definition to come...

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About NPI 1649553835

Spencer Lance Davenport, PA-C's National Provider Identifier is 1649553835, issued on Sep 23, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Ogden, UT. The record was last updated on Aug 10, 2021.