Organization
HAMMOND DERMATOLOGY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK PATRICK HENCHY III M.D. (OWNER)
(985) 542-9333
Entity
Organization
Contact information
Practice address
15709 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 542-9333
(985) 542-4988
Mailing address
15709 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 542-9333
(985) 542-4988
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9020
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1443841
—
LA
01
—
4093595
AETNA PROVIDER #
LA
01
—
439748825B
BLUE BROSS OF LA.
LA
Enumeration date
10/17/2006
Last updated
10/10/2007
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