Healthcare Provider Details

I. General information

NPI: 1336363050
Provider Name (Legal Business Name): JUNE STRICKLAND HENDERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE GOOCH DRIVE
WILLIAMSBURG VA
23187-8795
US

IV. Provider business mailing address

3328 RUNNING CEDAR WAY
WILLIAMSBURG VA
23188-2465
US

V. Phone/Fax

Practice location:
  • Phone: 757-221-4386
  • Fax: 757-221-1245
Mailing address:
  • Phone: 757-229-2546
  • Fax: 757-221-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number0101023275
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: