Healthcare Provider Details

I. General information

NPI: 1801888250
Provider Name (Legal Business Name): MICHAEL FREDERICK HENSLEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 ESTERS BLVD
BILOXI MS
39530-3134
US

IV. Provider business mailing address

115 ASHLEY PL
OCEAN SPRINGS MS
39564-5322
US

V. Phone/Fax

Practice location:
  • Phone: 228-435-3641
  • Fax: 228-435-4853
Mailing address:
  • Phone: 228-875-5571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number08138
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number08138
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: