Provider Demographics
NPI:1235184599
Name:HENRY, GUY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:MICHAEL
Last Name:HENRY
Suffix:
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 1:9600 LILE DR
Mailing Address - Street 2:SUITE 250 DOCTOR'S PARK BLDG.
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6326
Mailing Address - Country:US
Mailing Address - Phone:501-225-9905
Mailing Address - Fax:501-225-3323
Practice Address - Street 1:9600 LILE DR
Practice Address - Street 2:SUITE 250 DOCTOR'S PARK BLDG.
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6326
Practice Address - Country:US
Practice Address - Phone:501-225-9905
Practice Address - Fax:501-225-3323
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-3877174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR13906000000OtherQUALCHOICE
AR4204396OtherAETNA
AR769515OtherHEALTHLINK
AR163024001Medicaid
AR204033160OtherUNITED HEALTHCARE
AR13906000000OtherQUALCHOICE
ARP00369970Medicare PIN
AR163024001Medicaid
AR52201Medicare PIN