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NPI Code Detail

MEDICARE: DR. DONALD LENTZ HENSON JR. M.D.

MEDICARE: DR. DONALD LENTZ HENSON JR. M.D.
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
12084P0800XPsychiatry PhysicianMD0000021403TN

General Provider Information

NPI Number : 1245265925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD LENTZ HENSON JR. M.D.
Provider Business Mailing Address
First Line : 159 HAYS FARMS CT
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37615-4567
Country : US
Telephone Number : 423-202-1496
Fax Number :
Provider Business Practice Location Address
First Line : 3114 BROWNS MILL RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1417
Country : US
Telephone Number : 423-631-0432
Fax Number : 423-631-0284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 02/14/2024

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