Individual
CLYDE E HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 SMITH RD, SUITE B, NORWOOD, OH 45212-2793
(513) 221-4848
(513) 872-7825
Mailing address
PO BOX 637783, CINCINNATI, OH 45263-7783
(513) 853-4749
(513) 853-4740
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35042182
OH
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
35042182
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0386416
—
OH
Enumeration date
11/23/2005
Last updated
07/01/2014
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