Individual
JOHN RUCKER HENSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3265
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3265
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
013024
ME
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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