Henderson, Jeffrey Harris
Henderson, Jeffrey Harris is an individual health care provider with primary practice located at 170 Kimel Park Dr , Winston Salem NC 27103-6946. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Henderson, Jeffrey Harris can be contacted via phone (704) 323-2000.Contact Information
Primary practice address
170 Kimel Park Dr
Winston Salem NC 27103-6946
Phone: (704) 323-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 2011-00070 | North Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2011-00070 | North Carolina |
Profile Details
| NPI number | 1235386848 |
|---|---|
| LBN Legal business name | Henderson, Jeffrey Harris |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2008 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1235386848 | NPPES |
| North Carolina | MEDICAID | 1497704217 |
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