Brent W Henderson (NPI# 1649217746, PAC ID# 5496783912) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ANESTHESIOLOGY.
| Nation Provider ID (NPI) | 1649217746 |
| PAC ID by PECOS | 5496783912 |
| Professional Enrollment ID | I20051007000298 |
| Full Name | Brent W Henderson |
| Organization Legal Name | PMO MEDICAL PLLC |
| Address |
1751 N Aspen Ave Broken Arrow OK 74012-1197 |
| Phone Number | 9187946008 |
| Gender | M |
| Credential | DO |
| Medical School | OKLAHOMA COLLEGE OF OSTEOPATHIC MEDICINE AND SURGERY |
| Graduation Year | 2001 |
| Primary Specialty | ANESTHESIOLOGY |
| Group Practice PAC ID | 1153603832 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370112 | SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORIT |
| Address | Phone | Organization |
|---|---|---|
| 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 | 9187946008 | PMO MEDICAL PLLC |
| 601 E 13th St H, Pain Management of Oklahoma, Grove, OK 74344-2962 | 9187862243 | PMO MEDICAL PLLC |
| 555 W Ruth Ave, Sallisaw, OK 74955-6867 | 9187946008 | PMO MEDICAL PLLC |
| 401 E Broadway Ct A, Pain Management of Oklahoma, Sand Springs, OK 74063-7931 | 9182463456 | PMO MEDICAL PLLC |
| Organization Legal Name | PMO MEDICAL PLLC |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Claire Slaughter White | Nurse Practitioner | Pmo Medical Pllc | 601 E 13th St H, Pain Management of Oklahoma, Grove, OK 74344-2962 |
| Brianna L Youngwolfe | Nurse Practitioner | Pmo Medical Pllc | 701 W Queens St, 100 Pain Management of Oklahoma, Broken Arrow, OK 74012-1785 |
| Judy Vorheis | Nurse Practitioner | Pmo Medical Pllc | 1201 E Wade Watts Ave, Mcalester, OK 74501-5655 |
| Marilyn Sue Taylor | Physician Assistant | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Jack Shearer | Pain Management | Pmo Medical Pllc | 401 E Broadway Ct A, Pain Management of Oklahoma, Sand Springs, OK 74063-7931 |
| Jeffrey L Halford | Physical Medicine and Rehabilitation | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Jennifer L Campbell | Nurse Practitioner | Pmo Medical Pllc | 401 E Broadway Ct A, Pain Management of Oklahoma, Sand Springs, OK 74063-7931 |
| Harold Pierre | Anesthesiology | Pmo Medical Pllc | 401 E Broadway Ct A, Pain Management of Oklahoma, Sand Springs, OK 74063-7931 |
| Jo-anna Coppin Lohr | Nurse Practitioner | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Matthew Joseph Burrous | Nurse Practitioner | Pmo Medical Pllc | 601 E 13th St H, Pain Management of Oklahoma, Grove, OK 74344-2962 |
| Street Address |
1751 N ASPEN AVE |
| City | BROKEN ARROW |
| State | OK |
| Zip | 74012-1197 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marilyn Sue Taylor | Physician Assistant | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Jeffrey L Halford | Physical Medicine and Rehabilitation | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Jo-anna Coppin Lohr | Nurse Practitioner | Pmo Medical Pllc | 1751 N Aspen Ave, Broken Arrow, OK 74012-1197 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott M Hibbets | Optometry | 433 Stone Wood Dr, Broken Arrow, OK 74012-1026 | |
| Brad F Wells | Optometry | 433 Stone Wood Dr, Broken Arrow, OK 74012-1026 | |
| Travis D Ring | Chiropractic | 2433 N Aspen Ave, Broken Arrow, OK 74012-1142 | |
| Dena Marie Brunk | Physical Therapy | Redbud Physical Therapy LLC | 1700 W Albany St, Suite 310, Broken Arrow, OK 74012-1478 |
| Amira A Al Jiboori | Physical Therapy | Redbud Physical Rehabilitation PC | 1700 W Albany, Suite 310, Broken Arrow, OK 74012-1478 |
| Emily Lynne Sweeney | Physical Therapy | Redbud Physical Therapy LLC | 1700 W Albany St, Suite 310, Broken Arrow, OK 74012-1478 |
| Brian Coder | Family Medicine | Broken Arrow Family Clinic Inc | 705 W Oakland Ave, Broken Arrow, OK 74012-1626 |
| Carole C Howard | Family Medicine | Broken Arrow Family Clinic Inc | 705 W Oakland Ave, Broken Arrow, OK 74012-1626 |
| James A Coder Iii | Family Medicine | Broken Arrow Family Clinic Inc | 705 W Oakland Ave, Broken Arrow, OK 74012-1626 |
| Rachel L Whitehouse | Family Practice | Broken Arrow Family Clinic Inc | 705 W Oakland Ave, Broken Arrow, OK 74012-1626 |
| Find all physicians in zip 74012 | |||
| City | BROKEN ARROW |
| Zip Code | 74012 |
| Specialty | ANESTHESIOLOGY |
| City + Specialty | BROKEN ARROW + ANESTHESIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.