Provider Demographics
NPI:1083723829
Name:HENSEL, ALBERT E III (MD)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:E
Last Name:HENSEL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501
Mailing Address - Country:US
Mailing Address - Phone:931-520-1010
Mailing Address - Fax:931-520-0266
Practice Address - Street 1:220 N OAK AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-520-1010
Practice Address - Fax:931-520-0266
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000019559207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD0000019559Medicaid
TNMD0000019559Medicaid
3043453Medicare ID - Type Unspecified