Healthcare Provider Details

I. General information

NPI: 1104176882
Provider Name (Legal Business Name): WILLIAM C HENSON OD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 BLOWING ROCK RD STE A1
BOONE NC
28607-4600
US

IV. Provider business mailing address

1180 BLOWING ROCK RD STE A1
BOONE NC
28607-4600
US

V. Phone/Fax

Practice location:
  • Phone: 828-264-2020
  • Fax:
Mailing address:
  • Phone: 828-264-2020
  • Fax: 828-264-8918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM C HENSON
Title or Position: OWNER
Credential: OD
Phone: 828-264-2020