Basic Information
| Provider Information | |||||||||
| NPI: | 1801215348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENSLEY | ||||||||
| FirstName: | DENNY | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MDX, CBDT | ||||||||
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| Mailing Information | |||||||||
| Address1: | BLDG. 69, DOGWOOD AVE. | ||||||||
| Address2: | JAMES H. QUILLEN VAMC | ||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239261171 | ||||||||
| FaxNumber: | 4239793438 | ||||||||
| Practice Location | |||||||||
| Address1: | BLDG. 69, DOGWOOD AVE. | ||||||||
| Address2: | JAMES H. QUILLEN VAMC | ||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239261171 | ||||||||
| FaxNumber: | 4239793438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2014 | ||||||||
| LastUpdateDate: | 04/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471B0102X | MDX0000004820 | TN | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Bone Densitometry |
No ID Information.