Provider Demographics
NPI:1972680759
Name:HENRY, KATHRYN A (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:HENRY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1500 N WILMOT RD
Mailing Address - Street 2:SUITE 180C
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-886-4137
Mailing Address - Fax:520-886-5605
Practice Address - Street 1:1500 N WILMOT RD
Practice Address - Street 2:SUITE 180C
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-886-4137
Practice Address - Fax:520-886-5605
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ11469207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37009Medicare UPIN