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Individual

DR. JOHN PERRY HENDRIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
730 NORTHSIDE DR E, STATESBORO, GA 30458-4766
(912) 764-7352
(912) 681-8333
Mailing address
PO BOX 100, DEMOREST, GA 30535
(304) 887-2535
(912) 681-8333

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
920-OD
WV
152W00000X
Optometrist
Primary
GA-OPT000856
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010049211
VA
05
0150072000
WV
05
0150605001
WV
Enumeration date
03/09/2006
Last updated
05/05/2015
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