Individual
DR. CHRISTOPHER JERNARD HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3623 J DEWEY GRAY CIR, SUITE 113, AUGUSTA, GA 30909-6511
(706) 855-0422
Mailing address
9674 RED SQUIRREL LN, JACKSONVILLE, FL 32219-1993
(904) 742-4860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
054102
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689784589
GROUP NPI
GA
05
—
578944681B
—
GA
01
—
GRP7965
MEDICARE GIN
GA
01
—
P00392068
RR MEDICARE PIN
GA
Enumeration date
10/27/2006
Last updated
01/11/2010
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