Basic Information
| Provider Information | |||||||||
| NPI: | 1770946287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENSLEY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | DONOVAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 W. CHARLESTON BLVD | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712341 | ||||||||
| FaxNumber: | 7026712376 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 S WESTERN AVE | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731093413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056367000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2016 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 37713 | OK | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.