Phillip  K  Henderson    DO
Contract Details
USA Health System
Facility name
Provider ID
P000003541
NPI
1144450792
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
575 Stanton Road
Mobile, AL 36617
United States
County
Mobile
Phone
2514717207 (Phone)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Billing Phone
2514717207
Specialty Type
Internal Medicine
Map
Address