Provider Demographics
NPI:1346694163
Name:HENRY, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5599 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3821
Mailing Address - Country:US
Mailing Address - Phone:520-293-6740
Mailing Address - Fax:520-293-6771
Practice Address - Street 1:5599 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3821
Practice Address - Country:US
Practice Address - Phone:520-293-6740
Practice Address - Fax:520-293-6771
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ63223207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology