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Individual

DR. LANCE B. HENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1444 E STEARNS ST, SUITE 11, FAYETTEVILLE, AR 72703-6243
(479) 718-7546
(479) 966-4979
Mailing address
1444 E STEARNS ST, SUITE 11, FAYETTEVILLE, AR 72703-6243
(479) 718-7546
(479) 966-4979

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
244446
NY
207N00000X
Dermatology Physician
Primary
E-5162
AR
207ND0101X
MOHS-Micrographic Surgery Physician
244446
NY
207ND0101X
MOHS-Micrographic Surgery Physician
E-5162
AR
207ND0900X
Dermatopathology Physician
E-5162
AR
207NP0225X
Pediatric Dermatology Physician
244446
NY
207NP0225X
Pediatric Dermatology Physician
E-5162
AR
207NS0135X
Procedural Dermatology Physician
244446
NY
207NS0135X
Procedural Dermatology Physician
E-5162
AR

Other

Enumeration date
08/30/2006
Last updated
09/05/2012
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