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Individual

DR. ROBERT DAWSON HENDREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
107 PERRY ST, BLOOMFIELD, KY 40008
(502) 252-5081
(502) 252-7211
Mailing address
PO BOX 400, BLOOMFIELD, KY 40008
(502) 252-5081
(502) 252-7211

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16252
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000047085
ANTHEM
01
080025518
RAILROAD MEDICARE
01
1049276
PASSPORT
01
2448558000
PASSPORT
01
610963741B
HUMANA
05
64162522
KY
Enumeration date
05/10/2006
Last updated
05/07/2012
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