Individual
WARREN J HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 VERNON RD, SUITE 400, LAGRANGE, GA 30240
(706) 889-9341
(706) 884-0131
Mailing address
1602 VERNON RD, SUITE 400, LAGRANGE, GA 30240
(706) 882-9341
(706) 884-0131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20734
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000223935A
—
GA
05
—
000810850
—
AL
Enumeration date
06/19/2006
Last updated
10/10/2017
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