Individual
JOHN THOMAS HYDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495
Mailing address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
012493
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009853A
PEACH STATE
GA
01
—
00009853A
WELLCARE
GA
05
—
00009853A
—
GA
01
—
160051910
PALMETTO RAILROAD
GA
01
—
673289
BCBS
GA
Enumeration date
01/17/2007
Last updated
01/31/2012
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