Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK DAVID HENEISEN, M.D.
Active Sole ProprietorFamily Medicine · RINCON, GA
Registration Details
- NPI Number
- 1447310115
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 11, 2006 (19.370149602075 yrs)
- Last Updated
- Jul 8, 2007
- License
-
022780 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1214 N COLUMBIA AVE.UNIT DRINCON, GA, 31326Browse GA providers · Browse ZIP 31326
- Phone
- 9128262132
- Fax
- 9128262141
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in RINCON, GA
| Name | Credential | NPI |
|---|---|---|
| DR. CHRISTOPHER JOSEPH MATHEWS | M.D. | 1306845458 |
| DR. WILLERT HOWARD LYNN III | MD | 1174509145 |
| MELANIE MOONEY | M.D. | 1861462970 |
| MARIA E RIVERA | D.O | 1669447694 |
| JACQUELINE A CAFFREY | MD | 1063434165 |
| SUSAN R REINHEIMER | M.D. | 1437168499 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.