Individual
MARY ANN C. HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1930 BISHOP LN STE 1600, LOUISVILLE, KY 40218-1948
(502) 272-5044
(502) 272-5121
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21463
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000050975
ANTHEM / NCMA
—
01
—
000026447G
HUMANA / NCMA
—
01
—
008918
SIHO / NCMA
—
05
—
100360840
—
IN
01
—
110154477
RAILROAD MEDICARE
KY
01
—
1193602
CHA / NCMA
—
01
—
21433721000
PASSPORT ADVANTAGE / NCMA
—
01
—
2560873002
CIGNA
—
01
—
50015294
PASSPORT / NCMA
—
05
—
64214638
—
KY
Enumeration date
04/19/2006
Last updated
01/19/2021
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