Individual
ADAM JORDAN HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
916 N WASHINGTON STREET, DU QUOIN, IL 62832
(618) 790-7401
Mailing address
900 N WASHINGTON ST, DU QUOIN, IL 62832-1233
(618) 790-7401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036137639
IL
Other
Enumeration date
06/18/2012
Last updated
12/06/2023
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