Individual
NATHAN RAY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8970 MARKET ST, DOVER, AR 72837-9110
(479) 331-3880
(479) 331-3788
Mailing address
8970 MARKET ST, DOVER, AR 72837-9110
(479) 331-3880
(479) 331-3788
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E8951
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210379001
—
AR
Enumeration date
03/27/2013
Last updated
05/10/2017
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