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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801844931 NPPES
North Carolina MEDICAID 8941399

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