Provider Demographics
NPI:1497336572
Name:HENLEY PEDIATRICS PLLC
Entity Type:Organization
Organization Name:HENLEY PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZANE
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:HENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-276-1830
Mailing Address - Street 1:106 E MATLOCK CT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8319
Mailing Address - Country:US
Mailing Address - Phone:501-276-1830
Mailing Address - Fax:
Practice Address - Street 1:3604 CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6458
Practice Address - Country:US
Practice Address - Phone:501-276-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty