Mr David B Henderson, PA is a medicare enrolled "Physician Assistant" physician in Fayetteville, North Carolina. His current practice location is
1638 Owen Dr, Fayetteville, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(910) 609-4000.
Mr David B Henderson is licensed to practice in North Carolina (license number 100436) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184615239.
Physician's Profile
Full Name | Mr David B Henderson |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 1638 Owen Dr, Fayetteville, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1184615239
- Provider Enumeration Date: 10/28/2005
- Last Update Date: 07/12/2016
Medicare PECOS Information:
- PECOS PAC ID: 1759602881
- Enrollment ID: I20150602000475
Medical Identifiers
Medical identifiers for Mr David B Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184615239 | NPI | - | NPPES |
1184615239 | Other | | TRICARE |
1184615239 | Medicaid | SC | |
10436 | Other | NC | NORTH CAROLINA LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080A0000X | Pediatrics - Adolescent Medicine | 100436 (North Carolina) | Secondary |
363A00000X | Physician Assistant | 100436 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr David B Henderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr David B Henderson, PA Po Box 40908, Attn: Managed Care Planning, Fayetteville, NC 28309-0908 Ph: (910) 615-6949 | Mr David B Henderson, PA 1638 Owen Dr, Fayetteville, NC 28304-3424 Ph: (910) 609-4000 |
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