Healthcare Provider Details

I. General information

NPI: 1598853749
Provider Name (Legal Business Name): SADIE MAR HENRY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HOVEY RD
PENSACOLA FL
32508-1044
US

IV. Provider business mailing address

220 HOVEY RD
PENSACOLA FL
32508-1044
US

V. Phone/Fax

Practice location:
  • Phone: 850-452-3806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0102204244
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberDO.3434
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberXXXXXXX
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0102204244
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: