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NPI Code Detail

MEDICARE: DR. DALE HENNING M.D.

MEDICARE: DR. DALE HENNING 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
1207P00000XEmergency Medicine Physician24054KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649220518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DALE HENNING M.D.
Provider Business Mailing Address
First Line : 2323 LIME KILN LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-3416
Country : US
Telephone Number : 502-389-8000
Fax Number :
Provider Business Practice Location Address
First Line : 2323 LIME KILN LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-3416
Country : US
Telephone Number : 502-389-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 07/08/2007

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