Individual
AUDREY M HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1109 MEDICAL CENTER DR, SUITE 3, AUGUSTA, GA 30909-6644
(706) 860-4567
(706) 860-4489
Mailing address
1109 MEDICAL CENTER DR, SUITE 3, AUGUSTA, GA 30909-6644
(706) 860-4567
(706) 860-4489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
029884
GA
207Q00000X
Family Medicine Physician
Primary
GA029884
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00383897A
—
GA
Enumeration date
08/19/2005
Last updated
11/16/2016
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