Individual
DR. JONATHAN LEWIS HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 475-8523
(513) 475-7327
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3104
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
35 130416
OH
207RP1001X
Pulmonary Disease Physician
35 130416
OH
Other
Enumeration date
07/18/2008
Last updated
08/18/2017
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