Healthcare Provider Details

I. General information

NPI: 1134515406
Provider Name (Legal Business Name): BENJAMIN ADISON HENDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W SUNNYSIDE AVE
VISALIA CA
93277-7287
US

IV. Provider business mailing address

2300 W SUNNYSIDE AVE
VISALIA CA
93277-7287
US

V. Phone/Fax

Practice location:
  • Phone: 559-731-2009
  • Fax: 866-833-7251
Mailing address:
  • Phone: 559-731-2009
  • Fax: 866-833-7251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA172043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: