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Individual

JOHN ERIC HENRIKSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 HOSPITAL DRIVE, MAGNOLIA, AR 71753
(870) 235-3000
(870) 235-3557
Mailing address
PO BOX 629, MAGNOLIA, AR 71754-0629
(870) 235-3551
(870) 235-3557

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E2924
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E2924
AR MEDICAL BOARD
AR
Enumeration date
03/29/2006
Last updated
01/18/2008
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