Individual
JORDAN ANDREW HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572
(843) 692-5000
(843) 692-5010
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 429-5053
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
39910
SC
390200000X
Student in an Organized Health Care Education/Training Program
5101019226
MI
Other
Enumeration date
05/18/2011
Last updated
06/22/2018
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