Individual
DR. JOHN L HENAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
361 HIGHWAY 74 N, PEACHTREE CITY, GA 30269-1102
(770) 487-0667
(770) 487-0947
Mailing address
361 HIGHWAY 74 N, PEACHTREE CITY, GA 30269-1102
(770) 487-0667
(770) 487-0947
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001788
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00844181A
—
GA
01
—
721256052
TAX ID
LA
Enumeration date
10/31/2005
Last updated
08/01/2025
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