Individual
DR. JOHN FRANCIS MICHAEL HENNECKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 CADMAN PLZ W FL 18, BROOKLYN, NY 11201-3226
(929) 210-6135
Mailing address
2490 RIVERSIDE DR, STE B, MACON, GA 31204
(478) 633-6633
(478) 633-4295
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
035901
GA
207RC0000X
Cardiovascular Disease Physician
Primary
15076501
NY
207RC0000X
Cardiovascular Disease Physician
35901
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000508934I, J
—
GA
Enumeration date
07/03/2006
Last updated
05/18/2020
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