| Henderson Family Practice, Inc | |
|
403 Lister St Suite A Waycross GA 31501-5225 | |
| (912) 283-4422 | |
| (912) 283-4866 |
| Full Name | Henderson Family Practice, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 403 Lister St, Waycross, Georgia |
| Authorized Official Name and Position | Lori Tayman Henderson (FAMILY NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 9122834422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henderson Family Practice, Inc 403 Lister St Suite A Waycross GA 31501-5225 Ph: (912) 283-4422 | Henderson Family Practice, Inc 403 Lister St Suite A Waycross GA 31501-5225 Ph: (912) 283-4422 |
| NPI Number | 1629522032 |
|---|---|
| Provider Enumeration Date | 08/15/2016 |
| Last Update Date | 08/15/2016 |
| Medicare PECOS PAC ID | 4789971193 |
|---|---|
| Medicare Enrollment ID | O20160929000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629522032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | RN133742 (Georgia) | Primary |
| Provider Name | Lori Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871047399 PECOS PAC ID: 5698062008 Enrollment ID: I20160929000496 |
David H. Cheatham, M.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Beacon St, Waycross, GA 31501 Phone: 912-285-2440 Fax: 912-287-0197 | |
Southeast Georgia Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 Uvalda St, Waycross, GA 31501 Phone: 912-283-1359 Fax: 912-283-1362 | |
Thornton Family Chiropractic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Stephenson St, Waycross, GA 31501 Phone: 912-283-6043 Fax: 912-283-6043 | |
Southeast Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Riverside Dr, Waycross, GA 31501 Phone: 912-287-1555 | |
Packer Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Knight Ave, Waycross, GA 31501 Phone: 912-283-2311 Fax: 912-283-8204 | |
Satilla Family Medicine, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 407 W Oneida St, Waycross, GA 31501 Phone: 912-338-0065 Fax: 912-338-0920 | |
Waycross Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 Knight Ave, Waycross, GA 31501 Phone: 912-283-9423 Fax: 912-283-8204 |