Provider Demographics
NPI:1952732273
Name:STEPHEN B HENDERSON
Entity Type:Organization
Organization Name:STEPHEN B HENDERSON
Other - Org Name:NEW HOPE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-723-4245
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:AL
Mailing Address - Zip Code:35760-0469
Mailing Address - Country:US
Mailing Address - Phone:256-723-4245
Mailing Address - Fax:256-723-4243
Practice Address - Street 1:5398 MAIN DR
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:AL
Practice Address - Zip Code:35760-9115
Practice Address - Country:US
Practice Address - Phone:256-723-4245
Practice Address - Fax:256-723-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty