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General NPI Number Information
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NPI Number | 1770686933
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Entity Type | Organization
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Legal Business Name | DOUGLAS J HENKE MD PC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 1711 S STEPHENSON AVE SUITE 125
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3639
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Country | US
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Telephone | 906-779-4270
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Fax | 906-779-4276
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Provider Business Mailing Address
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Address Line | 1711 S STEPHENSON AVE SUITE 125
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3639
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Country | US
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Telephone | 906-779-4270
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Fax | 906-779-4276
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS JON HENKE
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Credential | M.D.
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Telephone | 906-779-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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