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General NPI Number Information
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NPI Number | 1518943505
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Entity Type | Individual
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Provider Name | LLOYD E HENDRIX MD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | DWIGHT D EISENHOWER VA MEDICAL CENTER 4101 4TH ST. TRAFFICWAY
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5014
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Country | US
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Telephone | 913-682-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 6740 GRANADA RD
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-1635
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Country | US
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Telephone | 920-284-0678
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 27660
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License Number State | WI
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