Organization
JOHN C. HENRY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA F HENRY (OFFICE MANAGER)
(575) 624-2330
Entity
Organization
Contact information
Practice address
207 N UNION AVE, SUITE C, ROSWELL, NM 88201-3068
(575) 624-2330
(575) 622-9133
Mailing address
207 N UNION AVE, SUITE C, ROSWELL, NM 88201-3068
(575) 624-2330
(575) 622-9133
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
83-218
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25239
—
NM
Enumeration date
10/05/2008
Last updated
10/05/2008
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