Henderson, Myra A

Henderson, Myra A is an individual health care provider with primary practice located at 1115 Woodland Dr , Elizabethtown KY 42701-2749. She recently has only one registered license in Allopathic & Osteopathic Physicians / Reproductive Endocrinology, which is considered as her primary health care specialty. Henderson, Myra A can be contacted via phone (270) 769-5963.

Contact Information

Primary practice address
1115 Woodland Dr Elizabethtown KY 42701-2749
Fax: (270) 769-9051
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 02554 Kentucky

Profile Details

NPI number 1427151430
LBN Legal business name Henderson, Myra A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Jan 9th, 2010 - 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 1427151430 NPPES
Kentucky MEDICAID 64025547

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