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Individual

MR. GLENN H HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1300 MICCOSUKEE RD, HOSPITALIST GROUP, TALLAHASSEE, FL 32308-5054
(850) 431-4997
(850) 431-6315
Mailing address
1300 MICCOSUKEE RD, HOSPITALIST GROUP, TALLAHASSEE, FL 32308-5054
(850) 431-4997
(850) 431-6315

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2228
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2907232
FL
Enumeration date
07/28/2006
Last updated
06/19/2014
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