Derek Joseph Davenport, MD
Derek Joseph Davenport, MD is a Pediatric Medicine in Eagle Mountain, Utah. Qualified in 2009, 17 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Oregon and Utah.
- Years since qualifying
- 17
- Licensed in
- OR, UT
- In the registry since
- 2009
- Specialties on file
- 4
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
4095 E Pony Express Pkwy Ste 1Eagle Mountain, UT 84005-5531
Phone: (801) 429-8037
Fax: (801) 753-7476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatrics Physician (primary) | Taxonomy 208000000X · Licence 11327523-1205 (UT) |
|---|---|
| Internal Medicine Physician | Taxonomy 207R00000X · Licence 11327523-1205 (UT) |
| Internal Medicine Physician | Taxonomy 207R00000X · Licence MD162235 (OR) |
| Pediatrics Physician | Taxonomy 208000000X · Licence MD162235 (OR) |
Record details
| NPI number | 1346484581 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | April 30, 2009 |
| Last updated in NPPES | November 27, 2023 |
| Certification date | June 2, 2020 |
Medicare enrollment
| Medicare specialty | PEDIATRIC MEDICINE |
|---|---|
| Also practises | INTERNAL MEDICINE |
| Medical school | OTHER |
| Graduated | 2009 (17 years in practice) |
| Group practice | Revere Health Pc — 410 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |