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General NPI Number Information
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NPI Number | 1013205863
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Entity Type | Organization
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Legal Business Name | RODNEY D. HENDERSON, M.D.
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 2851 S AVENUE B SUITE 2403
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City | YUMA
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State | AZ
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Zip | 85364-7726
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Country | US
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Telephone | 928-726-2990
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Fax | 928-726-0786
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Provider Business Mailing Address
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Address Line | 9187 CLAIREMONT MESA BLVD #6733
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City | SAN DIEGO
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State | CA
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Zip | 92123-1257
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Country | US
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Telephone | 928-726-2990
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Fax | 928-726-0786
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RODNEY D. HENDERSON
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Credential | M.D.
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Telephone | 928-726-2990
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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 | 44983
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License Number State | AZ
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