Henderson, Johnathan Edward
Henderson, Johnathan Edward is an sole proprietor health care provider with primary practice located at 304 Shorter Ave Nw Ste 201 , Rome GA 30165. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Henderson, Johnathan Edward can be contacted via phone (706) 509-3300.Contact Information
Primary practice address
304 Shorter Ave Nw Ste 201
Rome GA 30165
Phone: (706) 509-3300
Fax: (706) 509-3301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 054898 | Georgia |
Profile Details
| NPI number | 1154327856 |
|---|---|
| LBN Legal business name | Henderson, Johnathan Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Mar 10th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154327856 | NPPES |
| Georgia | Other | 0103487 | UNITED HEALTHCARE |
| Georgia | Other | P00177381 | UNITED HEALTHCARE |
| Georgia | Other | 6313 | UNITED HEALTHCARE |
| Georgia | Other | 388021 | UNITED HEALTHCARE |
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