Provider Demographics
NPI:1538190392
Name:HENNON, DON L (MD)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:L
Last Name:HENNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9576 PERRY HWY
Mailing Address - Street 2:SUITE 103 CRESTMONT BUILDING
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-367-3733
Mailing Address - Fax:412-367-7520
Practice Address - Street 1:9576 PERRY HWY
Practice Address - Street 2:SUITE 103 CRESTMONT BUILDING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-367-3733
Practice Address - Fax:412-367-7520
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD 007486 E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
801436OtherAETNA
PA06533010004Medicaid
100641OtherUPMC
968033OtherHMO BLUES
082803OtherHIGHMARK
968033OtherHMO BLUES
B35248Medicare UPIN