| Dr Keith Layne Henson, DO | |
|
8401 Market Street, C/o Medical Staff Office, Boardman, OH 44512 | |
| (330) 533-5699 | |
| (330) 702-1144 |
| Full Name | Dr Keith Layne Henson |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 8401 Market Street, Boardman, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023009412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34-00-3554 (Ohio) | Primary |
| Entity Name | Triad Health Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588925457 PECOS PAC ID: 9032367917 Enrollment ID: O20120918000787 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Keith Layne Henson, DO Po Box 3611, Boardman, OH 44513-3611 Ph: (330) 533-5699 | Dr Keith Layne Henson, DO 8401 Market Street, C/o Medical Staff Office, Boardman, OH 44512 Ph: (330) 533-5699 |
Mrs. Jessica Harriman Austin, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-480-2926 |
Dr. Thomas Nicholas Detesco, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 7341 Eisenhower Dr, Boardman, OH 44512 Phone: 330-726-1138 Fax: 330-726-6128 |
Dr. Thomas E Hunt, DO Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 7206 Market St Ste 100a, Boardman, OH 44512 Phone: 330-726-3379 Fax: 330-726-8683 |
Amer Aldamouk, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-729-1897 |
Manuel M Bautista, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Windham Ct, Suite 1, Boardman, OH 44512 Phone: 330-726-3357 Fax: 330-726-1465 |
Dr. Nicholas G Proia, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8423 Market St Ste 100, Boardman, OH 44512 Phone: 330-707-5864 Fax: 330-707-2210 |
Luis Henrique Marconcini, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-729-1591 |