MEDICARE: NICHOLAS LEVI HENSON M.D.

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
1	2085R0202X	Diagnostic Radiology Physician	069517	GA
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255599825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS LEVI HENSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9263
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31908-9263
Country	:	US
Telephone Number	:	706-320-2773
Fax Number	:	706-596-4226

Provider Business Practice Location Address
First Line	:	2122 MANCHESTER EXPY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6878
Country	:	US
Telephone Number	:	706-320-2773
Fax Number	:	706-596-4226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	02/11/2026

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