Doctor Name: | MR. DANIEL CALVIN HENSHAW |
NPI Number: | 1295992949 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | PA-239 |
Business Practice Address: | 550 W 121st St S Glenpool, OK - 740338677 |
Business Phone Number: | 9182915200 |
Business Fax Number: | 9182915929 |
Mailing Address: | 550 W 121st St S, GLENPOOL |
State: | OK |
Postal Code: | 740338677 |
Phone Number: | 9182915200 |
Fax Number: | 9182915929 |
NPI Enumeration Date: | 05/20/2008 |
NPI Last Update Date: | 01/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA-239 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |