Provider Demographics
NPI:1760864904
Name:HENDERSON, AUGUSTA DUNSE (DPM)
Entity Type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:DUNSE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:AUGUSTA
Other - Middle Name:K
Other - Last Name:DUNSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:397 WALLACE RD STE 411
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8028
Mailing Address - Country:US
Mailing Address - Phone:615-332-0330
Mailing Address - Fax:615-332-0340
Practice Address - Street 1:5073 COLUMBIA PIKE STE 230
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-8608
Practice Address - Country:US
Practice Address - Phone:615-302-5400
Practice Address - Fax:615-332-0340
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN836213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery