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General NPI Number Information
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NPI Number | 1851506661
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Entity Type | Individual
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Provider Name | JED WILLIAM HENRY MD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 1330 COSHOCTON AVE
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City | MOUNT VERNON
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State | OH
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Zip | 43050
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Country | US
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Telephone | 740-393-9000
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Fax | 740-392-0167
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Provider Business Mailing Address
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Address Line | 1330 COSHOCTON AVE
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City | MOUNT VERNON
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State | OH
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Zip | 43050
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Country | US
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Telephone | 740-393-9000
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Fax | 740-392-0167
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35091887
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 57.008944
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License Number State | OH
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