Edwin R Henson, MD | |
3201 W Gore Blvd, Suite 300, Lawton, OK 73505 | |
(580) 250-5824 | |
(580) 248-1964 |
Full Name | Edwin R Henson |
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Gender | Male |
Speciality | Pediatrics |
Location | 3201 W Gore Blvd, Lawton, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649265935 | NPI | - | NPPES |
5312321 | Other | OK | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 16952 (Oklahoma) | Primary |
Entity Name | Southwestern Surgical Affiliates, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013169531 PECOS PAC ID: 0941365308 Enrollment ID: O20090218000457 |
Mailing Address | Practice Location Address |
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Edwin R Henson, MD Po Box 785, Lawton, OK 73502 Ph: (580) 357-9984 | Edwin R Henson, MD 3201 W Gore Blvd, Suite 300, Lawton, OK 73505 Ph: (580) 250-5824 |
Dr. Sonia Allouch, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 5606 Sw Lee Blvd Ste 206, Lawton, OK 73505 Phone: 580-531-4875 | |
Laura White, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4202 Sw Lee Blvd, Building B, Suite 100, Lawton, OK 73505 Phone: 580-368-0808 | |
Dr. Edna C Solitario, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3201 W Gore Blvd, Suite 100, Lawton, OK 73505 Phone: 580-353-8942 Fax: 580-353-5008 | |
James Richard Marshall, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 3811 W Gore Blvd, Ste 6, Lawton, OK 73505 Phone: 580-355-5242 Fax: 580-355-5245 | |
Ajay Bhargava, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4302 Sw Lee Blvd, Lawton, OK 73505 Phone: 580-357-0058 Fax: 580-248-7667 | |
Dr. Elizabeth Gail Lewis, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2701 Sw Cornell Ave, Lawton, OK 73505 Phone: 580-248-0696 Fax: 580-357-7589 | |
Dr. Minda Unidad Roan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 110 Nw 31st St Ste 201, Lawton, OK 73505 Phone: 580-585-5549 Fax: 580-699-8223 |