Individual
DAVID J HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
440 MEDICAL DR STE 3, BOUNTIFUL, UT 84010-5174
(385) 722-9566
(385) 722-9567
Mailing address
280 S MAIN ST, BOUNTIFUL, UT 84010-6236
(801) 505-0821
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1593801205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05356
—
UT
05
—
1518109032
—
UT
Enumeration date
12/22/2005
Last updated
01/17/2025
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