Individual
DR. WILLIAM D HENCEROTH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
785 OHIO AVE, SUITE 1H, CLARKSDALE, MS 38614-6217
(662) 621-2438
(662) 621-2469
Mailing address
785 OHIO AVE, SUITE 1H, CLARKSDALE, MS 38614-6217
(662) 621-2438
(662) 621-2469
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101025812
VA
207X00000X
Orthopaedic Surgery Physician
21213
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010012449
—
VA
Enumeration date
09/14/2005
Last updated
03/16/2016
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