Healthcare Provider Details

I. General information

NPI: 1588141170
Provider Name (Legal Business Name): DR JAMES AARON HENLEY DO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 E 5TH AVE STE 105
OWASSO OK
74055-3484
US

IV. Provider business mailing address

314 E 5TH AVE STE 105
OWASSO OK
74055-3484
US

V. Phone/Fax

Practice location:
  • Phone: 918-608-0348
  • Fax: 918-923-3884
Mailing address:
  • Phone: 918-608-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4195
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES AARON HENLEY
Title or Position: OWNER
Credential: DO
Phone: 918-409-3497