Individual
JAMES G HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3415 53RD AVE, BETTENDORF, IA 52722-6976
(563) 742-4370
(309) 558-7026
Mailing address
3415 53RD AVE, BETTENDORF, IA 52722-6976
(563) 742-4370
(309) 558-7026
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33996
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750353223
—
IA
01
—
40379
WELLMARK
IA
01
—
P01170195
RR MEDICARE
IA
Enumeration date
02/07/2006
Last updated
02/05/2015
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