Individual
EDWARD HENEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
404 HIGHWAY 160, GAINESVILLE, MO 65655
(417) 679-4613
Mailing address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35006
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120405729
—
AR
Enumeration date
11/06/2006
Last updated
10/30/2023
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