MARY SUSAN HENDERSON M.D. NPI 1972539773

NPI Information

NPI: 1972539773
Provider Name: MARY SUSAN HENDERSON, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2729 S HIGHWAY 65 82
LAKE VILLAGE, AR
ZIP 71653
Phone: (870) 265-9380
Get Directions

Mary Susan Henderson, M.D. is an obstetrics gynecology in Lake Village, AR. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Mary Susan Henderson, M.D. NPI is 1972539773. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2729 S HIGHWAY 65 82
LAKE VILLAGE, AR
ZIP 71653-136
Phone: (870) 265-9380
Fax: (870) 265-9389

The NPI 1972539773 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 6/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology		E-4988	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	5N437	MEDICARE ID-TYPE UNSPECIFIED	LOUISIANA
2	1381659	MEDICAID	LOUISIANA
3	E75057	MEDICARE UPIN	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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