Edmond Charles Henson, M.D., P.H.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ACSC6534 Issued in AL

Practice address

19280 Howard Ave
Citronelle, AL 36522-2016

Phone

(251) 866-9811

NPI assigned

Feb 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306974704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "CITRONELLE",
            "state": "AL",
            "postal_code": "365220495",
            "telephone_number": "251-866-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19280 HOWARD AVE",
            "city": "CITRONELLE",
            "state": "AL",
            "postal_code": "365222016",
            "telephone_number": "251-866-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "EDMOND",
        "middle_name": "CHARLES",
        "credential": "M.D., P.H.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "ACSC6534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Encore Rehabilitation, Inc. (Encore Rehab of Citronelle)
• Freds Stores of Tennessee Inc (Freds Pharmacy 1259)
• Michael Clay Garver, DMD
• Gmuc of Citronelle LLC
• Hearts of Harmony Homecare LLC (hearts of harmony)
• Lymenda Hrinsin
• Thaila Keodouangdy
• Charles Lipe
• Mobile County Board of Health (Citronelle Clinic)
• Mobile County Board of Health (Citronelle Dental Clinic)

• Family Medicine Physician in Citronelle, AL
• Providers in Citronelle, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.