Healthcare Provider Details

I. General information

NPI: 1235295296
Provider Name (Legal Business Name): HENDREN AND LOCKETT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PERRY ST
BLOOMFIELD KY
40008
US

IV. Provider business mailing address

PO BOX 400
BLOOMFIELD KY
40008
US

V. Phone/Fax

Practice location:
  • Phone: 502-252-5081
  • Fax: 502-252-7211
Mailing address:
  • Phone: 502-252-5081
  • Fax: 502-252-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16252
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19893
License Number StateKY

VIII. Authorized Official

Name: DR. ROBERT D HENDREN
Title or Position: DOCTOR PARTNER
Credential:
Phone: 502-252-5081