Individual
DR. MARCUS ALAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1965 S FREMONT AVE, SUITE 100, SPRINGFIELD, MO 65804-2201
(417) 820-3800
(417) 820-3810
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2006012800
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952495780
—
MO
Enumeration date
10/03/2006
Last updated
10/03/2014
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