| Hendersons Minor Outpatient Medicine, Llc | |
|
1015 N Elm St Henderson KY 42420-2712 | |
| (270) 826-8009 | |
| (270) 826-7010 |
| Full Name | Hendersons Minor Outpatient Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1015 N Elm St, Henderson, Kentucky |
| Authorized Official Name and Position | David Watkins (PARTNER) |
| Authorized Official Contact | 2708268009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hendersons Minor Outpatient Medicine, Llc 1015 N Elm St Henderson KY 42420-2712 Ph: (270) 826-8009 | Hendersons Minor Outpatient Medicine, Llc 1015 N Elm St Henderson KY 42420-2712 Ph: (270) 826-8009 |
| NPI Number | 1811947070 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 02/03/2010 |
| Medicare PECOS PAC ID | 7719906171 |
|---|---|
| Medicare Enrollment ID | O20101025000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811947070 | NPI | - | NPPES |
| 65928160 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Garah E Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295783884 PECOS PAC ID: 6406745355 Enrollment ID: I20040310001575 |
| Provider Name | Zenaida A Maddela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487662011 PECOS PAC ID: 5890744882 Enrollment ID: I20050117000529 |
| Provider Name | Nhan H Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215018692 PECOS PAC ID: 5698701282 Enrollment ID: I20050714000808 |
| Provider Name | David A Watkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174571095 PECOS PAC ID: 8123102449 Enrollment ID: I20080516000690 |
| Provider Name | Charles H Futrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679751689 PECOS PAC ID: 0941371215 Enrollment ID: I20080612000906 |
| Provider Name | Scott A Watkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417905332 PECOS PAC ID: 6709957442 Enrollment ID: I20080624000223 |
| Provider Name | Thomas B Vincent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417397076 PECOS PAC ID: 9234360777 Enrollment ID: I20140325002113 |
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