IndividualActive
Connor Henson, IDMT
NPI 1083492870 · Independent Duty Medical Technicians · Moody Afb, GA
Provider details
- NPI number
- 1083492870
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
5178 Burma Rd
Moody Afb, GA 31699-0001
Phone: (918) 344-1110
Approximate (ZIP-level) locationGet directions
Mailing address
5178 Burma Rd
Moody Afb, GA 31699-0001
Registry dates
- Enumerated
- 2023-09-21
- Last updated
- 2026-01-29
- Certified
- 2026-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.