Provider Demographics
NPI:1215146956
Name:HENNESSEY, PATRICK THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:THOMAS
Last Name:HENNESSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1500 ABBOT RD
Mailing Address - Street 2:SUITE #400
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9998
Mailing Address - Country:US
Mailing Address - Phone:517-332-0100
Mailing Address - Fax:517-332-0356
Practice Address - Street 1:1500 ABBOT RD
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1222
Practice Address - Country:US
Practice Address - Phone:517-332-0100
Practice Address - Fax:517-332-0356
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2013-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD22205207Y00000X
MDD68392207Y00000X
MI4301103981207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology