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
Phone: (270) 769-5963
Fax: (270) 769-9051
Website:
Health care specialties
| Specialty | Code | License # | 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 15 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 | 1427151430 | NPPES |
| Kentucky | MEDICAID | 64025547 |
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