Individual
PETER HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6286 BRIARCREST AVE STE 200, MEMPHIS, TN 38120-4023
(901) 259-1600
(901) 259-1698
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5754
(901) 259-1600
(901) 259-1698
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
29216
MS
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
29216
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1R5931
MS MEDICARE
MS
01
—
29216
MS LICENSE
MS
01
—
64018
TN LICENSE
TN
01
—
T20468A
TN MEDICARE
TN
Enumeration date
04/23/2015
Last updated
08/25/2021
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