Henderson, Bradley E.

Henderson, Bradley E. is an sole proprietor health care provider with primary practice located at 1061 Harmon Ave Ste 1D03, Fort Stewart GA 31314-5641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Henderson, Bradley E. can be contacted via phone (912) 435-6933.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1D03 Fort Stewart GA 31314-5641
Phone: (912) 435-6933
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 030617 Georgia

Profile Details

NPI number 1578550133
LBN Legal business name Henderson, Bradley E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2005
Last updated Jan 12th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578550133 NPPES
Georgia MEDICAID 000391025B
Georgia MEDICAID 000391025E

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