Individual
LUKE BUTLER HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
653 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3903
Mailing address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
DO203696
OR
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
DO203696
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2014
Last updated
05/23/2023
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