Individual
EDWIN R HENSON III
Active
Individual
EDWIN R HENSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16952
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100030210C
SOONERCARE
OK
05
—
100030210D
—
OK
01
—
370015724
RAILROAD MEDICARE
OK
01
—
5312321
AETNA
OK
Enumeration date
09/13/2005
Last updated
03/21/2025
Update your record
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