| John M Henderson Do Pc | |
|
1900 10th Ave Ste 320 Columbus GA 31901-3610 | |
| (706) 323-5717 | |
| (706) 323-6010 |
| Full Name | John M Henderson Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1900 10th Ave Ste 320, Columbus, Georgia |
| Authorized Official Name and Position | John Mckenzie Henderson (PRESIDENT) |
| Authorized Official Contact | 7063235717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John M Henderson Do Pc 1900 10th Ave Ste 320 Columbus GA 31901-3610 Ph: (706) 323-5717 | John M Henderson Do Pc 1900 10th Ave Ste 320 Columbus GA 31901-3610 Ph: (706) 323-5717 |
| NPI Number | 1699947176 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 04/24/2024 |
| Medicare PECOS PAC ID | 3476537465 |
|---|---|
| Medicare Enrollment ID | O20040616001270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699947176 | NPI | - | NPPES |
| D45629 | Other | GA | UPIN |
| GRP6429 | Other | GA | MEDICARE GROUP |
| 08BBQVH | Other | GA | MEDICARE PROVIDER |
| 025765 | Other | GA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John M Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477597979 PECOS PAC ID: 3173421351 Enrollment ID: I20031226000001 |
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