Murdoc Michael Henderson, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Donalsonville, GA
NPI 1245299387 · NPPES record last updated Jan 31, 2012
Key facts
- NPI
- 1245299387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 049616 (GA)
- Practice address
- 900 N Wiley Ave
Donalsonville, GA 39845 - Phone
- (229) 524-8489
- Fax
- (229) 524-6237
- NPI assigned
- Mar 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049616 | GA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care of Southwest Georgia, Inc. | Current | Accepting new patients | |
| Primary Care of Southwest Georgia, Inc. | Current | Accepting new patients | |
| Early Memorial Hospital | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
360 College St
Blakely, GA 39823
Phone (229) 723-2660
Interoperability endpoints
- murdoc.henderson@pcswga.gadirect.net
- https://fhir4.healow.com/fhir/r4/CEIBAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 049616 | GA | Yes |
Addresses
Primary practice location
900 N Wiley Ave
Donalsonville, GA 39845
Mailing address
900 N Wiley Ave
Donalsonville, GA 39845
Phone (229) 524-8489
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 264430400 | Medicaid | FL | |
| 00894407B | Medicaid | GA | |
| 009972810 | Medicaid | AL |
Other providers in Donalsonville, GA
- Michael Hampton Jr.
- Sarah Walker Hampton
- Candice Nicole Hardeman
- Scott Hartzog
- Sherry R Hawkins
- Jacob Harvey Holley III
- Jeffrey Neal Holley
- Tukessa M Hopson
- Leslie Brooke Hornsby
- Mary M. Hunt
All providers in Donalsonville, GA · Obstetrics & Gynecology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.