Male or Other

Jonathan Henry MD

General Practice Physician in East Lansing, MI(View on Map)

Full Name

Jonathan Henry MD

NPI Number

1164470068

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/04/2006

Specialties

(Taxonomies)

Code

208D00000X
2084P0800X

Primary Taxonomy

Yes
No

Licenses

State

Michigan

License Number

4301046084

Contact
Information

Purpose

Mailing
Location

Address

4572 SOUTH HAGADORN
4572 SOUTH HAGADORN

City

East Lansing
East Lansing

State

MI
MI

Postal Code

48823-5355
48823-5355

Country

US
US

Telephone Number

(517) 349-8388
(517) 349-8388

Identifiers

Identifier

101923850

Identifier State

MI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/29/2016

Provider Address

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