Henao, Jose Luis

Henao, Jose Luis is an individual health care provider with primary practice located at 640 Flormann St , Rapid City SD 57701-4679. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Henao, Jose Luis can be contacted via phone (605) 755-3300.

Contact Information

Primary practice address
640 Flormann St Rapid City SD 57701-4679
Phone: (605) 755-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 13298 South Dakota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD2023-1540 New Mexico

Profile Details

NPI number 1275067613
LBN Legal business name Henao, Jose Luis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2017
Last updated Mar 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275067613 NPPES
New Mexico Other 6L7121 MEDICARE
New Mexico MEDICAID 15136728 MEDICARE

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