Hendricks, Sean David

Hendricks, Sean David is an individual health care provider with primary practice located at 4800 Maine St , Quincy IL 62305-5875. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Hendricks, Sean David can be contacted via phone (217) 223-8400.

Contact Information

Primary practice address
4800 Maine St Quincy IL 62305-5875
Phone: (217) 223-8400
Fax: (217) 214-0455
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 20248 Mississippi
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 42382 Tennessee
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 026330 Louisiana
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 036147214 Illinois

Profile Details

NPI number 1164583084
LBN Legal business name Hendricks, Sean David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Nov 27th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164583084 NPPES
Mississippi Other 302I182564 MEDICARE PTAN
Mississippi MEDICAID 00226767 MEDICARE PTAN

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