Individual
DR. THOMAS ALLEN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
722 S WAHSATCH AVE, COLORADO SPRINGS, CO 80903-4035
(719) 632-5700
(719) 344-7817
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
(719) 344-7837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39290
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09970754
—
CO
01
—
39290
COLORADO LICENSE
CO
Enumeration date
09/28/2006
Last updated
03/07/2023
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