Individual
THOMAS HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(908) 963-1655
Mailing address
PO BOX 1816, TAPPAHANNOCK, VA 22560-1816
(908) 963-1655
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA05596700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720095664
—
VA
05
—
5198801
—
NJ
Enumeration date
08/02/2006
Last updated
05/07/2009
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