| Dr Lance Raymond Henninger, MD | |
|
100 Brewster Blvd, Camp Lejeune, NC 28547-2538 | |
| (910) 450-4840 | |
| Not Available |
| Full Name | Dr Lance Raymond Henninger |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 100 Brewster Blvd, Camp Lejeune, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437160249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 23786 (Nebraska) | Secondary |
| 207P00000X | Emergency Medicine | 2015-00537 (North Carolina) | Primary |
| Entity Name | Wake Forest University Health Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lance Raymond Henninger, MD 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 Ph: (910) 450-4840 | Dr Lance Raymond Henninger, MD 100 Brewster Blvd, Camp Lejeune, NC 28547-2538 Ph: (910) 450-4840 |
Mr. Justin Thomas Daughtry, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4841 | |
Matthew Patrick Sullivan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547 Phone: 910-450-4159 Fax: 910-450-4194 | |
Dr. David Sullivan Axford, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 33 Holcomb Blvd, Camp Lejeune, NC 28547 Phone: 910-440-2463 | |
Liam Francis Delahanty, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 518-860-4677 | |
Dr. Ellie Lee Burns, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547 Phone: 910-450-4159 Fax: 910-450-4194 | |
Joshua David Simons, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4357 | |
Dr. Emanuel Jackson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4840 |