Henningsen, John T

Henningsen, John T is an individual health care provider with primary practice located at 1020 Lakeshore Dr , Rice Lake WI 54868. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Henningsen, John T can be contacted via phone (715) 236-8150.

Contact Information

Primary practice address
1020 Lakeshore Dr Rice Lake WI 54868
Phone: (715) 236-8150
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 15237 Wisconsin
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 15237 Wisconsin

Profile Details

NPI number 1578663225
LBN Legal business name Henningsen, John T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1578663225 NPPES
Wisconsin MEDICAID 30974800

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