Individual
DR. CHASE DOUGLAS HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 REDSTONE AVE W STE 410, CRESTVIEW, FL 32536-6457
(850) 306-2188
Mailing address
550 REDSTONE AVE W STE 410, CRESTVIEW, FL 32536-6457
(850) 306-2188
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME157502
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/03/2017
Last updated
06/16/2022
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