Individual
MARK J HENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
730 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-6644
(770) 228-5769
Mailing address
730 S 8TH ST, GRIFFIN, GA 30224-4827
(770) 228-6644
(770) 228-5769
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000897
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000871219A
—
GA
Enumeration date
09/29/2006
Last updated
02/03/2010
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