Organization
ALBERT E HENDERSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT EBEN HENDERSON MD (PHYSICIAN)
(912) 258-4075
Entity
Organization
Contact information
Practice address
330 OAK ST, SAINT SIMONS ISLAND, GA 31522-4725
(912) 258-4075
(912) 634-2371
Mailing address
330 OAK ST, SAINT SIMONS ISLAND, GA 31522-4725
(912) 258-4075
(912) 634-2371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
024948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00261522L
—
GA
Enumeration date
11/16/2010
Last updated
11/16/2010
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