Healthcare Provider Details

I. General information

NPI: 1225534654
Provider Name (Legal Business Name): NATHAN JAMES HENSLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42078 VETERANS AVE STE B
HAMMOND LA
70403-1490
US

IV. Provider business mailing address

8080 BLUEBONNET BLVD STE 1000
BATON ROUGE LA
70810-7827
US

V. Phone/Fax

Practice location:
  • Phone: 985-490-3070
  • Fax: 985-490-3082
Mailing address:
  • Phone: 225-924-2424
  • Fax: 225-408-7980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number327014
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: