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NPI Code Detail

MEDICARE: ANNE HENDERSON MD

MEDICARE: ANNE HENDERSON MD
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
12086H0002XHospice and Palliative Medicine (Surgery) Physician60759AZ
22086S0129XVascular Surgery Physician50759AZ

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 : 1972767580
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE HENDERSON MD
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 350 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4496
Country : US
Telephone Number : 602-406-3000
Fax Number : 602-212-4768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2008
Last Update Date : 06/18/2026

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