Individual
JASON LOY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 ROCKEFELLER DR, MUSKOGEE, OK 74401-5075
(918) 502-1900
(918) 494-6303
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34-009344
OH
207R00000X
Internal Medicine Physician
5300
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5300
OK
207RP1001X
Pulmonary Disease Physician
Primary
5300
OK
Other
Enumeration date
06/28/2007
Last updated
01/02/2025
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