Henderson, Richard
Henderson, Richard is an individual health care provider with primary practice located at 1609 N Dixie Hwy , Elizabethtown KY 42701-6473. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Henderson, Richard can be contacted via phone (270) 765-7372.Contact Information
Primary practice address
1609 N Dixie Hwy
Elizabethtown KY 42701-6473
Phone: (270) 765-7372
Fax: (270) 737-3936
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1217DT | Kentucky |
Profile Details
| NPI number | 1669537528 |
|---|---|
| LBN Legal business name | Henderson, Richard |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1669537528 | NPPES |
| Kentucky | MEDICAID | 77012177 |
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