Individual
DR. ROY A HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3231 S NATIONAL AVE, SUITE 100, SPRINGFIELD, MO 65807-7304
(417) 885-0810
(417) 888-6740
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R5B75
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109802001
—
AR
05
—
201591336
—
MO
01
—
24543
MO BLUE SHIELD
MO
01
—
82174
ARK BLUE SHIELD
AR
Enumeration date
02/13/2007
Last updated
10/18/2011
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