Individual
DR. JOHN C HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, SUITE M261, KALAMAZOO, MI 49007-5341
(269) 488-2626
(269) 488-2625
Mailing address
601 JOHN ST, SUITE M261, KALAMAZOO, MI 49007-5341
(269) 488-2626
(269) 488-2625
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301033379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107985
GREAT LAKES HLTH PLAN
—
01
—
1803968251
BCBS PIN
MI
05
—
4238221-10
—
MI
05
—
4999314
—
MI
01
—
5276514
AETNA PIN
—
Enumeration date
06/14/2006
Last updated
12/15/2014
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