| Doctor Name: | DR. TAMMY N HENDERSON |
| NPI Number: | 1801997606 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 13886 |
| Business Practice Address: | 9325c Highway 19 N Collinsville, MS - 393259219 |
| Business Phone Number: | 6016267108 |
| Business Fax Number: | 6016267975 |
| Mailing Address: | 9325c Highway 19 N, COLLINSVILLE |
| State: | MS |
| Postal Code: | 393259219 |
| Phone Number: | 6016267108 |
| Fax Number: | 6016267975 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 06/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13886 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |