Karol J Hendrickson DO PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

5101012173 Issued in MI

Legal business name

KAROL J HENDRICKSON DO PC

Practice address

4669 12TH Rd
Escanaba, MI 49829-9605

Phone

(906) 786-9391

NPI assigned

Jun 29, 2009

Last updated

Jul 30, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cynthia R Moore

Title

Credentialing Specialist

Phone

(734) 207-5226

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1922236942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4669 12TH RD",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498299605",
            "telephone_number": "906-786-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4669 12TH RD",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498299605",
            "telephone_number": "906-786-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAROL J HENDRICKSON DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "734-207-5226",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": "5101012173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lige Johnson
• Stephanie Johnson
• Breanna Lynn Kadish
• Kylie Kalishek
• Anthony V Kamerschen, MD
• Michael G Keeker, MD
• Kent E. Anderson, M.D. P.C.
• Mary R Kidd, APNP
• Darren Kinnunen, LLMSW
• Carmen S Kleikamp, LMSW

• Adult Medicine Physician in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Adult Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.