Individual
DR. BONNY DAWN HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1855 W MAIN ST, NEWARK, OH 43055-1135
(614) 257-5200
Mailing address
6607 CLARK STATE RD, BLACKLICK, OH 43004-9657
(614) 204-4922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4745
OH
152W00000X
Optometrist
Primary
OH4745/T1549
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000116079
ANTHEM BLUE CROSS
OH
Enumeration date
07/08/2005
Last updated
03/21/2022
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