Individual
JOHN CHAPPELL HENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4212 W CONGRESS ST, SUITE 3200, LAFAYETTE, LA 70506-6765
(337) 273-2863
(337) 984-5428
Mailing address
4212 W CONGRESS ST, SUITE 3200, LAFAYETTE, LA 70506-6765
(337) 273-2863
(337) 984-5428
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
A10268
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624799
—
LA
01
—
970014804
RR MEDICARE
LA
Enumeration date
12/14/2005
Last updated
10/06/2009
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