Individual
MRS. GWENDOLYN HENDRIX-BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2204 E MAIN ST, STIGLER, OK 74462-2822
(918) 967-9200
Mailing address
906 NW 7TH ST, P. O. BOX 593, STIGLER, OK 74462-1504
(918) 967-9200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1150
OK
Other
Enumeration date
02/21/2006
Last updated
06/28/2011
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