Provider Demographics
NPI:1659416493
Name:HENRY, AMY S (DO)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:HENRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8594 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-1142
Mailing Address - Country:US
Mailing Address - Phone:812-616-4062
Mailing Address - Fax:866-902-0798
Practice Address - Street 1:8594 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-1142
Practice Address - Country:US
Practice Address - Phone:812-616-4062
Practice Address - Fax:866-902-0798
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY03103207Q00000X
IN11012827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
U80035Medicare UPIN