Ronald Russell Henrickson, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

4778 Issued in MT

Practice address

32318 Bisson LN
Polson, MT 59860-7354

Phone

(406) 883-5723

NPI assigned

Sep 23, 2008

Last updated

Sep 23, 2008By 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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1902056252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32318 BISSON LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598607354",
            "telephone_number": "406-883-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32318 BISSON LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598607354",
            "telephone_number": "406-883-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "RONALD",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MT",
            "license": "4778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Paul Hebert, RPH
• Jason T Heintz, D.D.S.
• Kathleen Heiskell, MSW, LCSW
• Kacie K Hendricks, PHARMD
• Jeffrey Donald Heninger, O.D.
• Hobby Horse Place LLC (Debbie McGuinness Physical Therapy)
• Home Caregivers, Inc.
• Jeremy Houk
• Joseph Allen Howard, MD
• Ashlee Olivia Howell, DPT

• Otolaryngology/Facial Plastic Surgery Physician in Polson, MT
• Providers in Polson, MT by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.