Provider Demographics
NPI:1942948203
Name:HENSLEY, CALVIN (DPM)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9273 GUINEA STATION RD
Mailing Address - Street 2:
Mailing Address - City:WOODFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22580-3203
Mailing Address - Country:US
Mailing Address - Phone:831-917-9234
Mailing Address - Fax:
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6478
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program