Provider Demographics
NPI:1194729061
Name:HENDERSON, LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEIGHT
Other - Middle Name:
Other - Last Name:RANSONET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-812-7800
Mailing Address - Fax:501-812-7215
Practice Address - Street 1:9501 BAPTIST HEALTH DR FL 1
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6225
Practice Address - Country:US
Practice Address - Phone:501-202-7395
Practice Address - Fax:501-202-7333
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022103208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1053315846OtherGROUP NPI NUMBER
LA1666751Medicaid
LA250013408OtherRAILROAD MEDICARE
LA1666751Medicaid
LA1053315846OtherGROUP NPI NUMBER
LA5W2736742Medicare PIN