Ms Lauren I Henderson, MD | |
1550 Mulkey Rd, Austell, GA 30106-1112 | |
(707) 321-1377 | |
(770) 732-2081 |
Full Name | Ms Lauren I Henderson |
---|---|
Gender | Female |
Speciality | Dermatology |
Location | 1550 Mulkey Rd, Austell, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669817011 | NPI | - | NPPES |
003244191G | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 86208 (Georgia) | Primary |
Entity Name | Atlanta West Deramtology, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174680979 PECOS PAC ID: 9638135692 Enrollment ID: O20041202000177 |
Mailing Address | Practice Location Address |
---|---|
Ms Lauren I Henderson, MD 1550 Mulkey Rd, Austell, GA 30106-1112 Ph: (770) 732-1137 | Ms Lauren I Henderson, MD 1550 Mulkey Rd, Austell, GA 30106-1112 Ph: (707) 321-1377 |
Latrice M Hogue, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 770-732-1137 Fax: 770-732-2081 | |
Janice Murphy Warner, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 404-446-1440 Fax: 770-732-2081 | |
Dr. Louis Jack Herskowitz, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1790 Mulkey Rd, Suite 1, Austell, GA 30106 Phone: 770-941-1013 Fax: 770-941-9418 |