Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 31092 | MN |
Y | 207RI0011X | Interventional Cardiology | 31092 | MN |
NPI | 1114987997 |
---|---|
Provider Name | Timothy D Henry |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 27/10/2020 |