Henderson, Roy

Henderson, Roy is an individual health care provider with primary practice located at 14535A Hazel Dell Pkwy , Carmel IN 46033-9401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Henderson, Roy can be contacted via phone (317) 705-4360.

Contact Information

Primary practice address
14535A Hazel Dell Pkwy Carmel IN 46033-9401
Phone: (317) 705-4360
Fax: (317) 705-4361
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-104711 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01075456A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036104711 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 01075456A Indiana

Profile Details

NPI number 1861426694
LBN Legal business name Henderson, Roy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861426694 NPPES
Illinois MEDICAID 036104711
Illinois MEDICAID 201291730

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