Doctor Name: | MRS. AMY M HALLAL HENDERSON |
NPI Number: | 1437159886 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01052944A |
Business Practice Address: | 5130 Charlestown Rd Suite 2 New Albany, IN - 471509483 |
Business Phone Number: | 8129491577 |
Business Fax Number: | 8129497985 |
Mailing Address: | 5130 Charlestown Rd, Suite 2 NEW ALBANY |
State: | IN |
Postal Code: | 471509483 |
Phone Number: | 8129491577 |
Fax Number: | 8129497985 |
NPI Enumeration Date: | 07/28/2005 |
NPI Last Update Date: | 04/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01052944A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |