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Individual

DR. THOMAS JAMES HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
913 N DIXIE AVE, DEPARTMENT OF EMERGENCY MEDICINE, ELIZABETHTOWN, KY 42701-2503
(877) 783-6257
Mailing address
913 N DIXIE AVE, DEPARTMENT OF EMERGENCY MEDICINE, ELIZABETHTOWN, KY 42701-2503
(877) 783-6257

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01068464A
IN
207P00000X
Emergency Medicine Physician
Primary
45465
KY
207P00000X
Emergency Medicine Physician
MT188168
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000766878
BCBS
KY
05
200987820
IN
01
50037788
PASSPORT
KY
05
7100174620
KY
Enumeration date
05/23/2008
Last updated
05/02/2014
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