Provider Demographics
NPI:1801831458
Name:DOENLEN, HENRY A (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:A
Last Name:DOENLEN
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 1:1120 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2608
Mailing Address - Country:US
Mailing Address - Phone:850-434-5033
Mailing Address - Fax:850-433-0268
Practice Address - Street 1:1120 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2608
Practice Address - Country:US
Practice Address - Phone:850-434-5033
Practice Address - Fax:850-433-0268
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME552562084P0804X, 2084P0802X
AL320842084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09274ZMedicare PIN