Doctor Name: | MARGOT D HENDERSON |
NPI Number: | 1023092822 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C. |
License Number: | 2798 |
Business Practice Address: | 1755 Airway Ave Kingman, AZ - 864093620 |
Business Phone Number: | 9286811234 |
Business Fax Number: | 9286811811 |
Mailing Address: | 3900 Stockton Hill Rd Ste B368, KINGMAN |
State: | AZ |
Postal Code: | 864093029 |
Phone Number: | 9286811234 |
Fax Number: | 9286811811 |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 01/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 2798 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |