Individual
SCOTT A. HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3399 E. LOUISE DR., #400, MERIDIAN, ID 83642
(208) 364-3000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7975
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020445995
RAILROAD MEDICARE
—
05
—
805748100
—
ID
01
—
M7975
STATE LICENSE #
ID
Enumeration date
05/16/2006
Last updated
08/09/2013
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