Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OT013473 | PA |
NPI | 1003132044 |
---|---|
Provider Name | Joseph W Hensley |
First Address | Johnstown, PA 15905-4305 |
Second Address | Johnstown, PA 15905-4305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 15/04/2010 |