Individual
POLLY A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER, DULUTH, GA 30096-4506
(215) 762-3937
(215) 762-5600
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
068190
GA
207W00000X
Ophthalmology Physician
MD425936
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101262870
—
PA
Enumeration date
06/12/2006
Last updated
01/07/2022
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