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MR. RANDOLPH HAYES HENDERSON PHYSICIAN ASSISTANT
NPI 1366530545
Physician Assistant in Jackson, MS

Active since October 11, 2006
1500 E WOODROW WILSON DRIVE, G V MONTGOMERY DEPARTMENT OF VETERANS AFFAIRS, JACKSON, MS 39216(601) 362-4471(601) 364-1325 Get Directions Write a Review

NPPES record last updated: July 11, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Randolph Hayes Henderson Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RANDOLPH HAYES HENDERSON PHYSICIAN ASSISTANT (NPI 1366530545) is an individual physician assistant in Jackson, Mississippi, licensed in Mississippi (PA001) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1366530545
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. RANDOLPH HAYES HENDERSONCredential: PHYSICIAN ASSISTANT
Location Address1500 E WOODROW WILSON DRIVE, G V MONTGOMERY DEPARTMENT OF VETERANS AFFAIRSJackson, MS 39216-5199
Mailing Address4223 Adams Station RoadEdwards, MS 39066 · (601) 885-2022 · Fax (601) 956-3468
Phone(601) 362-4471
Fax(601) 364-1325
Sole ProprietorNo
Enumeration DateOctober 11, 2006
Last NPPES UpdateJuly 11, 2007
✔ NPI 1366530545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MS · PA001
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1500 E WOODROW WILSON DRIVE, Jackson, MS 39216
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN DENISE RANSBURG-GARNER NP
Nurse Practitioner (Family)
1500 E WOODROW WILSON DRIVE
JACKSON, MS 39216
Hinds County (601) 362-4471
MRS. JULIA STEWART BURNETT LCSW
Social Worker (Clinical)
1500 E WOODROW WILSON DRIVE
JACKSON, MS 39216
Hinds County (601) 362-4471
DR. ROY RUSSELL REEVES DO
Psychiatry & Neurology (Psychiatry)
1500 E WOODROW WILSON DRIVE, VA MED CENTER - PSYCHIATRY 11M
JACKSON, MS 39216
Hinds County (601) 368-4152
MR. JOHN A. MCGOWAN R.PH.
Pharmacist
1500 E WOODROW WILSON DRIVE
JACKSON, MS 39216
Hinds County (601) 364-1555
SANDRA R CHRISTMAS FNP
Nurse Practitioner (Family)
1500 E WOODROW WILSON DRIVE
JACKSON, MS 39216
Hinds County (601) 362-4471

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph Henderson's NPI number?

The NPI number for Randolph Henderson is 1366530545. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Randolph Henderson located?

Randolph Henderson practices at 1500 E Woodrow Wilson Drive G V Montgomery Department Of Veterans Affairs, Jackson, MS 39216. The listed phone number is (601) 362-4471.

What is Randolph Henderson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Randolph Henderson was last updated on July 11, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.