Organization
HBISC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OWEN HENDRICKS MD (CEO)
(404) 245-3900
Entity
Organization
Contact information
Practice address
3118 ESPLANADE CIR SW, ATLANTA, GA 30311-4221
(404) 245-3900
Mailing address
PO BOX 42944, ATLANTA, GA 30311
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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