Mr Randolph Hayes Henderson, PHYSICIAN ASSISTANT - Physician Assistant in Jackson, MS

Mr Randolph Hayes Henderson, PHYSICIAN ASSISTANT is a Physician Assistant based in Jackson, Mississippi. Mr Randolph Hayes Henderson is licensed to practice in Mississippi (license number PA001) and his current practice location is 1500 E Woodrow Wilson Drive, G V Montgomery Department Of Veterans Affairs, Jackson, Mississippi. He can be reached at his office (for appointments etc.) via phone at (601) 362-4471.

NPI number for Mr Randolph Hayes Henderson is 1366530545 and his current mailing address is 4223 Adams Station Road, Edwards, Mississippi. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1366530545.

Contact Information

Mr Randolph Hayes Henderson, PHYSICIAN ASSISTANT
1500 E Woodrow Wilson Drive, G V Montgomery Department Of Veterans Affairs,
Jackson, MS 39216-5199
(601) 362-4471
(601) 364-1325

Map and Direction




Provider's Profile

Full NameMr Randolph Hayes Henderson
GenderMale
SpecialityPhysician Assistant
Location1500 E Woodrow Wilson Drive, Jackson, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1366530545
  • Provider Enumeration Date: 10/11/2006
  • Last Update Date: 07/11/2007

Medical Identifiers

Medical identifiers for Mr Randolph Hayes Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366530545NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant PA001 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Randolph Hayes Henderson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Randolph Hayes Henderson, PHYSICIAN ASSISTANT
4223 Adams Station Road,
Edwards, MS 39066

Ph: (601) 885-2022
Mr Randolph Hayes Henderson, PHYSICIAN ASSISTANT
1500 E Woodrow Wilson Drive, G V Montgomery Department Of Veterans Affairs,
Jackson, MS 39216-5199

Ph: (601) 362-4471

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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