Individual
DR. JOHN HENDERSON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1327 STADIUM DR, MACON, GA 31207-1302
(478) 301-2382
(478) 301-2391
Mailing address
790 LAKE FRANCES DR APT 5, CHARLESTON, SC 29412-4337
(678) 447-3683
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
078835
GA
207R00000X
Internal Medicine Physician
LL36863
SC
Other
Enumeration date
06/17/2014
Last updated
07/21/2022
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