Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 35093284 | OH |
NPI | 1033294152 |
---|---|
Provider Name | Andrew Jennings Hendershot |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43212-3153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2992605 | (05) | OH |