Individual
DR. TAMMY N HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9325C HIGHWAY 19 N, COLLINSVILLE, MS 39325-9219
(601) 626-7108
(601) 626-7975
Mailing address
9325C HIGHWAY 19 N, COLLINSVILLE, MS 39325-9219
(601) 626-7108
(601) 626-7975
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13886
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121471
—
MS
01
—
13886
MS LICENSE NUMBER
MS
Enumeration date
09/26/2006
Last updated
06/04/2013
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