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Contact Information

BRENT HENDERSON, DO
8801 S 101ST EAST AVE
TULSA, OK74133-5716
 Phone: 918-294-4915
 Fax: 918-294-4947
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for BRENT HENDERSON · (Male)

NPI # 1649217746
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/31/2006
Last updated 04/19/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 3954
  • OK Medicaid 200059770A
  • OK Other 900522349 MEDICARE GROUP PIN
Hospital affiliation(s)
  • SEQUOYAH MEMORIAL HOSPITAL - (Acute Care)
    213 EAST REDWOOD
    SALLISAW, OK 74955
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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