Henderson, Everett Randall
Henderson, Everett Randall is an sole proprietor health care provider with primary practice located at 6051 U S Highway 49 , Hattiesburg MS 39401-7200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Henderson, Everett Randall can be contacted via phone (601) 288-3440.Contact Information
Primary practice address
6051 U S Highway 49
Hattiesburg MS 39401-7200
Phone: (601) 288-3440
Fax: (601) 288-3451
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 14669 | Mississippi |
Profile Details
| NPI number | 1609904515 |
|---|---|
| LBN Legal business name | Henderson, Everett Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Jul 8th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609904515 | NPPES |
| Mississippi | MEDICAID | 0117106 |
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