Henry, Robert A.

Henry, Robert A. is an individual health care provider with primary practice located at 2817 New Pinery Road , Portage WI 53901-9257. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Henry, Robert A. can be contacted via phone (608) 742-4131.

Contact Information

Primary practice address
2817 New Pinery Road Portage WI 53901-9257
Phone: (608) 742-4131
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X H1102 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 65243-21 Wisconsin

Profile Details

NPI number 1740240308
LBN Legal business name Henry, Robert A.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Mar 24th, 2016 - about 10 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 1740240308 NPPES
Texas Other 807629 BLUE SHIELD
Texas MEDICAID 1010845-02 BLUE SHIELD
Texas Other 080161793 BLUE SHIELD
Texas Other 1010845-01 BLUE SHIELD

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