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General NPI Number Information
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NPI Number | 1003899667
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Entity Type | Individual
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Provider Name | DEBORAH A HENLEY MD
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Gender | Female
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 160 ALLEN STREET MEDICAL STAFF SERVICES
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City | RUTLAND
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State | VT
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Zip | 05701
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Country | US
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Telephone | 802-747-3639
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Fax | 802-747-6207
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Provider Business Mailing Address
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Address Line | 160 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4560
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Country | US
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Telephone | 802-775-2937
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Fax | 802-773-2204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1973931
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 197393-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 042-0011335
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License Number State | VT
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