National Provider Identifier Database

TYKERRIA R HENDERSON
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

TYKERRIA R HENDERSON
30 PINEHURST ST
PORT GIBSON, MS39150-2850
Phone: 931-278-9365
Fax:
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X

* Indicates primary specialty

NPI Profile & details for TYKERRIA R HENDERSON

NPI Number 1104775865
Credentials
Entity Individual
Enumeration date 01/26/2026
Last updated 01/26/2026 - About 4 months ago
Sole proprietor1 No
Identifiers
  • MS License #: 922851
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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