Henderson, Eva Mae

Henderson, Eva Mae is an individual health care provider with primary practice located at 350 W Woodrow Wilson Ave , Jackson MS 39213-7681. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Henderson, Eva Mae can be contacted via phone (601) 709-5150.

Contact Information

Primary practice address
350 W Woodrow Wilson Ave Jackson MS 39213-7681
Phone: (601) 709-5150
Fax: (601) 709-5151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 10119 Mississippi

Profile Details

NPI number 1033146725
LBN Legal business name Henderson, Eva Mae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Jun 6th, 2011 - about 14 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 1033146725 NPPES
Louisiana MEDICAID 1692743
Louisiana MEDICAID 00116298

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