Individual
GARY I HENDRICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 W LYON ST, TALLAPOOSA, GA 30176-1288
(770) 824-2800
(770) 824-2810
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
029670
GA
Other
Enumeration date
07/25/2006
Last updated
06/22/2010
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