Individual
RAYMOND BRUCE HENTHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
316 5TH ST, MARIETTA, OH 45750-3027
(740) 374-3556
(740) 374-3577
Mailing address
316 5TH ST, MARIETTA, OH 45750-3027
(740) 374-3556
(740) 374-3577
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
12681
WV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
35 048319
OH
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
35048319
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050235000
—
WV
05
—
0539939
—
OH
Enumeration date
06/14/2005
Last updated
11/24/2021
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