| Doctor Name: | ERIC A DAVENPORT |
| NPI Number: | 1386004950 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RD |
| License Number: | BDNDTN00223320 |
| Business Practice Address: | 4900 Houston Rd Florence, KY - 410424824 |
| Business Phone Number: | 8592124625 |
| Business Fax Number: | 8592124638 |
| Mailing Address: | 2300 Chamber Center Dr, Suite 300 LAKESIDE PARK |
| State: | KY |
| Postal Code: | 410171686 |
| Phone Number: | 8593443945 |
| Fax Number: | 8593445552 |
| NPI Enumeration Date: | 02/25/2016 |
| NPI Last Update Date: | 02/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | BDNDTN00223320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |