Organization
DOUGLAS J HENKE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS JON HENKE M.D. (PRESIDENT)
(906) 779-4270
Entity
Organization
Contact information
Practice address
1711 S STEPHENSON AVE, SUITE 125, IRON MOUNTAIN, MI 49801-3639
(906) 779-4270
(906) 779-4276
Mailing address
1711 S STEPHENSON AVE, SUITE 125, IRON MOUNTAIN, MI 49801-3639
(906) 779-4270
(906) 779-4276
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30730800
—
WI
05
—
3285138
—
MI
Enumeration date
09/06/2006
Last updated
12/12/2012
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