Hendricks, Mark Vining

Hendricks, Mark Vining is an individual health care provider with primary practice located at 840 Pine Street Suite 780, Macon GA 31201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Hendricks, Mark Vining can be contacted via phone (478) 744-2445.

Contact Information

Primary practice address
840 Pine Street Suite 780 Macon GA 31201
Phone: (478) 744-2445
Fax: (478) 744-0906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 043061 Georgia
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 043061 Georgia

Profile Details

NPI number 1306827639
LBN Legal business name Hendricks, Mark Vining
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Oct 26th, 2012 - about 13 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 1306827639 NPPES
Georgia MEDICAID 000904219A
Georgia Other 290013678

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