Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 07000510A | IN |
Y | 213E00000X | Podiatrist | 07000510A | IN |
Y | 222Z00000X | Podiatrist | 07000510A | IN |
NPI | 1285620732 |
---|---|
Provider Name | Dr. Bryan E Hendrix |
First Address | Indianapolis, IN 46268-6129 |
Second Address | Indianapolis, IN 46268-6129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 20/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T34567 | (02) |