Individual
RANDALL E. HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 S CLEVELAND AVE, WESTERVILLE, OH 43081-8971
(614) 898-6659
(614) 898-8631
Mailing address
PO BOX 20452, COA-CRED, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35054430
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35054430
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0660897
—
OH
Enumeration date
07/19/2005
Last updated
09/26/2023
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