Provider Demographics
NPI:1841273646
Name:HENSLEIGH, KATHERINE A (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:HENSLEIGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:ARMISTEAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1404 E PUSHMATAHA ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:AL
Mailing Address - Zip Code:36904-2728
Mailing Address - Country:US
Mailing Address - Phone:205-459-4400
Mailing Address - Fax:205-459-4010
Practice Address - Street 1:1404 E PUSHMATAHA ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:AL
Practice Address - Zip Code:36904-2728
Practice Address - Country:US
Practice Address - Phone:205-459-4400
Practice Address - Fax:205-459-4010
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00004519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-13777OtherBCBS AL
AL511-13777OtherBCBS AL
AL102I085907Medicare PIN