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Organization

MENA INTERNAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID HENDERSON MD (OWNER)
(479) 437-3602
Entity
Organization

Contact information

Practice address
531 POLK 77, MENA, AR 71953-7848
(479) 437-3602
(479) 437-3604
Mailing address
531 POLK 77, MENA, AR 71953-7848
(479) 437-3602
(479) 437-3604

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E3000
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
145341002
AR
Enumeration date
04/02/2007
Last updated
08/14/2009
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