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NPI Code Detail

MEDICARE: DR. MARK HENRY HENNINGTON MD

MEDICARE: DR. MARK HENRY HENNINGTON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician17118NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23760384OTHERNCCAROLINA CARE PLAN (PHP)

General Provider Information

NPI Number : 1093776619
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK HENRY HENNINGTON MD
Provider Business Mailing Address
First Line : 420 N CENTER ST
Second Line :
City : HICKORY
State : NC
Zip : 28601-5046
Country : US
Telephone Number : 828-323-1100
Fax Number : 828-324-9189
Provider Business Practice Location Address
First Line : 420 N CENTER ST
Second Line :
City : HICKORY
State : NC
Zip : 28601-5046
Country : US
Telephone Number : 828-323-1100
Fax Number : 828-324-9189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 11/23/2009

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