Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 023459 | GA |
N | 207RP1001X | Pulmonary Disease | 023459 | GA |
NPI | 1154329951 |
---|---|
Provider Name | Dr. Stephen Gregory Hendrix |
First Address | Savannah, GA 31406-3928 |
Second Address | Savannah, GA 31406-3928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 05/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000251512H | (05) | GA |
408552 | BCBS (01) | GA |
D40115 | (02) | |
G23459 | (05) | SC |