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General NPI Number Information
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NPI Number | 1699947176
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Entity Type | Organization
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Legal Business Name | JOHN M HENDERSON DO PC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 1900 10TH AVE STE 320
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City | COLUMBUS
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State | GA
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Zip | 31901-3610
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Country | US
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Telephone | 706-323-5717
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Fax | 706-323-6010
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Provider Business Mailing Address
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Address Line | 1900 10TH AVE STE 320
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City | COLUMBUS
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State | GA
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Zip | 31901-3610
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Country | US
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Telephone | 706-323-5717
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Fax | 706-323-6010
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN MCKENZIE HENDERSON SR.
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Credential | DO
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Telephone | 706-323-5717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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