Most Relevant Information
Provider Data
| NPI Number: | 1003599648 |
| Provider Name: | ERIC HENDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 1127699 |
Most Important Dates
| Enumeration Date: | 08/10/2023 |
| Last Updated: | 08/15/2023 |
Provider Practice Location
6600 VAN AALST BLVD
FORT MOORE
GA
319052102
Practice Location Phone/Fax
| Phone: | 7624083107 |
| Fax: |
Provider Mailing Location
4926 CEDAR RIDGE CT
COLUMBUS
GA
319092081
Provider Mailing Phone/Fax
| Phone: | 7065771123 |
| Fax: |