Healthcare Provider Details

I. General information

NPI: 1891180592
Provider Name (Legal Business Name): ERIK STEVEN HENKELMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6265 ROCK CHALK DR
LAWRENCE KS
66049-5232
US

IV. Provider business mailing address

6265 ROCK CHALK DR
LAWRENCE KS
66049-5232
US

V. Phone/Fax

Practice location:
  • Phone: 785-843-9125
  • Fax: 785-505-5312
Mailing address:
  • Phone: 785-312-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number04-43343
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: