Organization
INTERNAL MEDICINE OF SOUTHEAST GEORGIA
Active
Organization
INTERNAL MEDICINE OF SOUTHEAST GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. S LANCE HENDRIX MD (PRESIDENT)
(912) 530-6582
Entity
Organization
Contact information
Practice address
351 PEACHTREE ST, JESUP, GA 31545-0245
(912) 530-6582
(912) 530-6584
Mailing address
351 PEACHTREE ST, JESUP, GA 31545-0245
(912) 530-6582
(912) 530-6584
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189166661B
—
GA
01
—
2781716
UNITED HEALTHCARE
GA
01
—
DF9280
RAILROAD MEDICARE GROUP
GA
01
—
N371138
WELLCARE
GA
Enumeration date
05/02/2007
Last updated
11/07/2025
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