Henigan, Mark Hamilton

Henigan, Mark Hamilton is an sole proprietor health care provider with primary practice located at 1729 Tully Rd Suite Eight, Modesto CA 95350-4082. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Henigan, Mark Hamilton can be contacted via phone (209) 544-8363.

Contact Information

Primary practice address
1729 Tully Rd Suite Eight Modesto CA 95350-4082
Phone: (209) 544-8363
Fax: (209) 758-0995
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 20A6351 California
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 20A6351 California

Profile Details

NPI number 1689897365
LBN Legal business name Henigan, Mark Hamilton
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2007
Last updated Jul 21st, 2008 - about 16 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 1689897365 NPPES
California MEDICAID 9519325

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