Derek Joseph Davenport, MD is a medicare enrolled "Pediatrics" physician in Eagle Mountain, Utah. His current practice location is
4095 E Pony Express Pkwy Ste 1, Eagle Mountain, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 429-8037.
Derek Joseph Davenport is licensed to practice in Utah (license number 11327523-1205) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1346484581.
Physician's Profile
| Full Name | Derek Joseph Davenport |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 4095 E Pony Express Pkwy Ste 1, Eagle Mountain, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Derek Joseph Davenport attended and graduated from in
NPI Data:
- NPI Number: 1346484581
- Provider Enumeration Date: 04/30/2009
- Last Update Date: 11/27/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Derek Joseph Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346484581 | NPI | - | NPPES |
| 1346484581 | Other | | NPI |
| 500659989 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 11327523-1205 (Utah) | Secondary |
| 207R00000X | Internal Medicine | MD162235 (Oregon) | Secondary |
| 208000000X | Pediatrics | MD162235 (Oregon) | Secondary |
| 208000000X | Pediatrics | 11327523-1205 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derek Joseph Davenport is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Derek Joseph Davenport, MD
1055 N 500 W, Attn. Credentialing,
Provo, UT 84604
Ph: (801) 354-8225 | Derek Joseph Davenport, MD
4095 E Pony Express Pkwy Ste 1,
Eagle Mountain, UT 84005-5531
Ph: (801) 429-8037 |
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