Provider Demographics
NPI:1194833657
Name:HENARD, JOHN EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EUGENE
Last Name:HENARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-0306
Mailing Address - Country:US
Mailing Address - Phone:423-357-5211
Mailing Address - Fax:
Practice Address - Street 1:211 COLLINS ST
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:TN
Practice Address - Zip Code:37642-4016
Practice Address - Country:US
Practice Address - Phone:423-357-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC 461OtherJOHN DEERE
TN3671021Medicaid
TN0000355OtherBLUE CROSS
TN0000355OtherBLUE CROSS
TNC 461OtherJOHN DEERE