Henderson, Keith
Henderson, Keith is an individual health care provider with primary practice located at 1638 Owen Dr , Fayetteville NC 28304-3424. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Henderson, Keith can be contacted via phone (910) 609-4592.Contact Information
Primary practice address
1638 Owen Dr
Fayetteville NC 28304-3424
Phone: (910) 609-4592
Fax: (910) 609-5179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 9400073 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 9400073 | North Carolina |
Profile Details
| NPI number | 1801844931 |
|---|---|
| LBN Legal business name | Henderson, Keith |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Jul 15th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801844931 | NPPES |
| North Carolina | MEDICAID | 8941399 |
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