Healthcare Provider Details

I. General information

NPI: 1700840519
Provider Name (Legal Business Name): STEPHEN L HENSLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 PLAZA DR
COLD SPRING KY
41076
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-442-1530
  • Fax: 859-442-1501
Mailing address:
  • Phone: 859-912-6500
  • Fax: 859-442-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22371
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: