Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | E-5108 | AR |
Y | 207XS0106X | Orthopaedic Hand Surgeon | E5108 | AR |
NPI | 1023031168 |
---|---|
Provider Name | Dr. Christopher Noel Henley |
First Address | Fayetteville, AR 72702-1608 |
Second Address | Fayetteville, AR 72703-4056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 12/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164463001 | (05) | AR |
200852500 | (05) | IN |
E-5108 | MEDICAL LICENSE (01) | AR |