Individual
PATTY KRISTAL HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
195 E TOLLISON ST, BAXLEY, GA 31513-0120
(912) 367-0434
(912) 367-0436
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-0434
(912) 367-0436
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
060851
GA
207V00000X
Obstetrics & Gynecology Physician
35077380
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01063
—
ND
05
—
474244127A
—
GA
Enumeration date
10/20/2006
Last updated
10/21/2021
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