Individual
DR. KEITH LAYNE HENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8401 MARKET STREET, C/O MEDICAL STAFF OFFICE, BOARDMAN, OH 44512
(330) 533-5699
(330) 702-1144
Mailing address
PO BOX 3611, BOARDMAN, OH 44513-3611
(330) 533-5699
(330) 702-1144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34-00-3554
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0585817
—
OH
Enumeration date
11/03/2005
Last updated
12/06/2011
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