Individual
DR. JOHN R HENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(316) 686-6888
(316) 686-9358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-20156
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055561
MEDICARE
KS
01
—
080148468
RAILROAD MEDICARE
KS
01
—
DN4213
RAILROAD MEDICARE PTAN
KS
Enumeration date
08/29/2006
Last updated
04/23/2025
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