Individual
DR. EVA MAE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 W WOODROW WILSON AVE, JACKSON, MS 39213-7681
(601) 709-5150
(601) 709-5151
Mailing address
PO BOX 3437, JACKSON, MS 39207-3437
(601) 362-5321
(601) 354-5159
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10119
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116298
—
MS
05
—
1692743
—
LA
Enumeration date
06/27/2006
Last updated
06/06/2011
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