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NPI Code Detail

MEDICARE: JOHN WALTER HENDRIX III M.D.

MEDICARE: JOHN WALTER HENDRIX III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician29030SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538283718
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WALTER HENDRIX III M.D.
Provider Business Mailing Address
First Line : 408 WEST ALEXANDER AVENUE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-4031
Country : US
Telephone Number : 864-227-9393
Fax Number : 864-227-9377
Provider Business Practice Location Address
First Line : 408 WEST ALEXANDER AVENUE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-4031
Country : US
Telephone Number : 864-227-9393
Fax Number : 864-227-9377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/24/2020

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