Healthcare Provider Details

I. General information

NPI: 1285657551
Provider Name (Legal Business Name): DON LEWIS HENSLEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 H ST
FAIRBURY NE
68352-1119
US

IV. Provider business mailing address

PO BOX 277
FAIRBURY NE
68352-0277
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-3351
  • Fax:
Mailing address:
  • Phone: 402-729-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number15241
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberR3J60
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number19060
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: