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General NPI Number Information
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NPI Number | 1225035488
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Entity Type | Individual
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Provider Name | RODNEY D HENDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2005
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 2851 S AVENUE B STE 2403
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City | YUMA
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State | AZ
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Zip | 85364-7759
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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 |
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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 | 105849
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License Number State | MO
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