Healthcare Provider Details

I. General information

NPI: 1972590164
Provider Name (Legal Business Name): FRANK PATRICK HENCHY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15709 PROFESSIONAL PLZ
HAMMOND LA
70403-1452
US

IV. Provider business mailing address

PO BOX 3087
HAMMOND LA
70404-3087
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-9333
  • Fax: 985-542-4988
Mailing address:
  • Phone: 985-230-1682
  • Fax: 985-230-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number9020
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: