Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bibomba Davenport

Individual provider Prosthetics Case Management · NPI 1679901995

Bibomba Davenport is a Prosthetics Case Management in Smyrna, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2013
Specialties on file
3

Practice location Address checks out

2690 Mt Wilkinson Pkwy SE 22
Smyrna, GA 30080-3020
Phone: (404) 510-2604
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X
Prosthetics Case Management Taxonomy 1744P3200X · Licence 1744P3200X (GA)
Prosthetic/Orthotic Supplier Taxonomy 335E00000X

Record details

NPI number1679901995
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 23, 2013
Last updated in NPPESMay 31, 2023
Certification dateMay 22, 2023
Mailing address2690 Mt Wilkinson Pkwy Se, 22, Smyrna, GA 30080

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