Patty Kristal Henry, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Baxley, GA
NPI 1689757155 · NPPES record last updated Oct 21, 2021
Key facts
- NPI
- 1689757155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 060851 (GA)
- Practice address
- 195 E Tollison St
Baxley, GA 31513-0120 - Phone
- (912) 367-0434
- Fax
- (912) 367-0436
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35077380 | OH | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Baxley and Appling County Hospital Authority | Past | Accepting new patients | |
| Wiley G Woodard MD Inc | Obstetrics & Gynecology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35077380 | OH | |
| Obstetrics & Gynecology Physician | 207V00000X | 060851 | GA | Yes |
Addresses
Primary practice location
195 E Tollison St
Baxley, GA 31513-0120
Mailing address
PO Box 2070
Baxley, GA 31515-2070
Phone (912) 367-0434
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474244127A | Medicaid | GA | |
| 01063 | Medicaid | ND |
Other providers in Baxley, GA
- Lisa Lynn Hall
- Ashlynn Hampton
- Gwenetta A Harris
- Healthie Community Center LLC
- Joseph C Hegarty
- Matthew Hodges
- Bryan Lanier Holmes Sr.
- Leonard F Howard
- Erica Paige Howell
- Cassandra M Hower
All providers in Baxley, GA · Obstetrics & Gynecology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.