Individual
JONATHAN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4572 SOUTH HAGADORN, 2A EAST, EAST LANSING, MI 48823-5355
(517) 349-8388
(517) 349-1560
Mailing address
4572 SOUTH HAGADORN, 2A EAST, EAST LANSING, MI 48823-5355
(517) 349-8388
(517) 349-1560
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301046084
MI
208D00000X
General Practice Physician
Primary
4301046084
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101923850
—
MI
Enumeration date
05/04/2006
Last updated
11/29/2016
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