Individual
DR. PETER L HENDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 HOSPITAL DR, SUITE 6, CHATSWORTH, GA 30705-2070
(706) 695-9240
(706) 695-9241
Mailing address
PO BOX 12938, CALHOUN, GA 30703-7013
(706) 602-7800
(706) 879-5843
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2010-00324
NC
208600000X
Surgery Physician
Primary
27386
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4720
GROUP #
—
Enumeration date
09/25/2006
Last updated
11/08/2016
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