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Individual

DR. FREDERIC ALAN HENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
810 S 6TH ST, SUITE D, MONTICELLO, IN 47960-8201
(574) 583-6446
(574) 583-3060
Mailing address
810 S 6TH ST, SUITE D, MONTICELLO, IN 47960-8201
(574) 583-6446
(574) 583-3060

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01030491
IN
207Q00000X
Family Medicine Physician
Primary
01030491
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080004174
MEDICARE RAILROAD
IN
05
100079510
IN
Enumeration date
07/25/2006
Last updated
07/24/2009
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