Individual
DR. CHARLES H HERNDON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1104 PROFESSIONAL BLVD, DALTON, GA 30720-2588
(706) 226-5533
(706) 428-0033
Mailing address
101 N CASTLE RD, DALTON, GA 30720-8002
(706) 278-8220
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
013818
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
013818
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00136991A
—
GA
01
—
023789
BCBS EDI
GA
Enumeration date
10/02/2006
Last updated
09/11/2025
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