Organization
MAX A HENRY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON CAMERON (OFFICE MANAGER)
(812) 372-4463
Entity
Organization
Contact information
Practice address
301 HENRY ST, SUITE 200, NORTH VERNON, IN 47265-1030
(812) 346-3858
(812) 346-3588
Mailing address
301 HENRY ST, SUITE 200, NORTH VERNON, IN 47265-1030
(812) 346-3858
(812) 346-3588
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
01034054A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200823550C
—
IN
Enumeration date
06/02/2009
Last updated
06/22/2009
Update your record
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