Provider Demographics
NPI:1699722892
Name:HENSON, PAUL EDWARD III (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:HENSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CLEVELAND ST STE 350
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-2898
Mailing Address - Country:US
Mailing Address - Phone:931-423-6970
Mailing Address - Fax:423-697-1798
Practice Address - Street 1:49 CLEVELAND ST STE 350
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-2898
Practice Address - Country:US
Practice Address - Phone:931-459-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD029178208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3060926Medicare ID - Type Unspecified