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General NPI Number Information
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NPI Number | 1558618645
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Entity Type | Organization
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Legal Business Name | PAMELA S. HENDERSON, M.D., P.C.
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Dates
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Enumeration Date | 08/08/2012
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 7425 E SHEA BLVD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6411
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Country | US
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Telephone | 480-596-6886
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Fax | 480-596-8989
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Provider Business Mailing Address
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Address Line | 7425 E SHEA BLVD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6411
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Country | US
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Telephone | 480-596-6886
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Fax | 480-596-8989
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. PAMELA S HENDERSON
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Credential | M.D.
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Telephone | 480-596-6886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 22689
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License Number State | AZ
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