Henderson, David

Henderson, David is an individual health care provider with primary practice located at 531 Polk 77 , Mena AR 71953-7848. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Henderson, David can be contacted via phone (479) 437-3602.

Contact Information

Primary practice address
531 Polk 77 Mena AR 71953-7848
Phone: (479) 437-3602
Fax: (479) 437-3604
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X E3000 Arkansas

Profile Details

NPI number 1306995527
LBN Legal business name Henderson, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Aug 14th, 2009 - about 17 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 1306995527 NPPES
Arkansas Other E3000 STATE LICENSE #
Arkansas Other 5L920 STATE LICENSE #
Arkansas MEDICAID 145341001 STATE LICENSE #

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