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NPI Code Detail

MEDICARE: MICHAEL W. HENNIGAN, P.A.

MEDICARE: MICHAEL W. HENNIGAN, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistME0064533FL

General Provider Information

NPI Number : 1134391857
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL W. HENNIGAN, P.A.
Provider Business Mailing Address
First Line : 1847 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4640
Country : US
Telephone Number : 850-914-8618
Fax Number : 850-914-8669
Provider Business Practice Location Address
First Line : 1847 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4640
Country : US
Telephone Number : 850-914-8618
Fax Number : 850-914-8669
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL HENNIGAN
Credential : M.D.
Telephone Number : 850-914-8618
Provider Enumeration Date : 04/02/2008
Last Update Date : 09/22/2010

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