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Individual

DR. JOHN TYLER HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
900 S. LIMESTONE, CTW 304, LEXINGTON, KY 40536-0293
(859) 323-6561
Mailing address
900 S. LIMESTONE, CTW 304, LEXINGTON, KY 40536-0293

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
61906
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/28/2022
Last updated
04/07/2026
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