Individual
MARGOT D HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1755 AIRWAY AVE, KINGMAN, AZ 86409-3620
(928) 681-1234
(928) 681-1811
Mailing address
3900 STOCKTON HILL RD STE B368, KINGMAN, AZ 86409-3029
(928) 681-1234
(928) 681-1811
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2798
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
827149
—
AZ
01
—
P00256908
RAILROAD MEDICARE
AZ
Enumeration date
12/05/2005
Last updated
01/21/2016
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