Individual
JASON LEMARR HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 HOVEY RD, NAVAL AEROSPACE MEDICINE INSTITUTE, PENSACOLA, FL 32508-1044
(850) 452-9484
Mailing address
366 MIZZEN LN, PENSACOLA, FL 32507-8681
(757) 271-3494
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
0101238546
VA
2085R0202X
Diagnostic Radiology Physician
Primary
ME157587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114629300
—
FL
01
—
84NCY
BCBS
FL
01
—
QD404
MEDICARE PTAN OHMG
FL
01
—
QD405
MEDICARE PTAN OHRI
FL
Enumeration date
01/16/2006
Last updated
03/28/2023
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