Dr Terry Evert Davenport, DO is a medicare enrolled "Family Medicine" physician in St Maries, Idaho. His current practice location is
229 S 8th St, St Maries, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 245-2591.
Dr Terry Evert Davenport is licensed to practice in Idaho (license number O-130) 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 1710974191.
Physician's Profile
| Full Name | Dr Terry Evert Davenport |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 229 S 8th St, St Maries, Idaho |
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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:
- Dr Terry Evert Davenport attended and graduated from in
NPI Data:
- NPI Number: 1710974191
- Provider Enumeration Date: 09/30/2005
- Last Update Date: 11/15/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Terry Evert Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710974191 | NPI | - | NPPES |
| 601415700 | Other | | DEEIOC |
| S1303 | Other | ID | BLUE CROSS OF ID |
| 123363 | Other | WA | DEPT OF LABOR&INDUSTRIES |
| 8434839 | Medicaid | WA | |
| 805169900 | Medicaid | ID | |
| 000010004699 | Other | ID | REGENCE BS OF ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208M00000X | Hospitalist | O-130 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | O-130 (Idaho) | 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. Dr Terry Evert 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 |
|---|
Dr Terry Evert Davenport, DO
229 S 8th St,
St Maries, ID 83861-1813
Ph: (208) 245-2591 | Dr Terry Evert Davenport, DO
229 S 8th St,
St Maries, ID 83861-1813
Ph: (208) 245-2591 |
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