Individual
DR. JOHN M. HENDERSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1900 10TH AVE SUITE 320, COLUMBUS, GA 31901
(706) 323-5717
(855) 681-1414
Mailing address
1900 10TH AVE SUITE 320, COLUMBUS, GA 31901
(706) 323-5717
(706) 323-6010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025765
STATE LICENSE
GA
Enumeration date
06/15/2006
Last updated
04/24/2024
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