Mark Shea Henderson, MD | |
135 Plaza Dr, Suite 202, Sikeston, MO 63801-5136 | |
(573) 472-6003 | |
(573) 472-7159 |
Full Name | Mark Shea Henderson |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 135 Plaza Dr, Sikeston, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639139876 | NPI | - | NPPES |
8BF145 | Other | TX | BCBS |
113358901 | Medicaid | TX | |
113358905 | Medicaid | TX | |
113358906 | Medicaid | TX | |
113358907 | Medicaid | TX | |
990010000 | Other | TX | MCARE RR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | J4200 (Texas) | Primary |
Entity Name | Woodlands Health Group, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902389521 PECOS PAC ID: 2567706500 Enrollment ID: O20181203002228 |
Mailing Address | Practice Location Address |
---|---|
Mark Shea Henderson, MD 135 Plaza Dr, Suite 202, Sikeston, MO 63801-5136 Ph: (573) 472-6003 | Mark Shea Henderson, MD 135 Plaza Dr, Suite 202, Sikeston, MO 63801-5136 Ph: (573) 472-6003 |
Kevin P Rankin, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1015 N Main St, Sikeston, MO 63801 Phone: 573-472-7120 Fax: 573-472-7129 | |
Dr. Boris Frohman, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1008 N Main St, Sikeston, MO 63801 Phone: 573-472-7318 Fax: 573-472-7757 | |
Eric Butler, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1008 N Main St, Sikeston, MO 63801 Phone: 573-471-1600 | |
Dr. Ryan Jon Dalisky, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 1124 N Main St, Sikeston, MO 63801 Phone: 573-475-7501 | |
Dr. Paul F. Montany, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1019 N Main St, Sikeston, MO 63801 Phone: 573-472-7702 Fax: 573-472-7719 | |
Razvan Iorga, M.D. Surgery Medicare: Medicare Enrolled Practice Location: Missouri Delta Medical Center, 1008 N. Main St, Sikeston, MO 63801 Phone: 573-471-1600 |