Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 59769 | AZ |
N | 207X00000X | Orthopaedic Surgeon | 7571 | GA |
NPI | 1023491230 |
---|---|
Provider Name | Dr. Andrew Thomas Henderson |
First Address | Scottsdale, AZ 85258-5067 |
Second Address | Scottsdale, AZ 85258-5067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2015 |
Last Update Date | 20/07/2020 |