DR. PETER L HENDERSON JR. (NPI# 1902906084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902906084 |
| Entity Type | Individual |
| Full Name | DR. PETER L HENDERSON JR. |
| Credential | MD |
| Practice Address |
106 Hospital Dr Suite 6 Chatsworth GA 30705-2070 |
| Mailing Address |
Po Box 12938 Calhoun GA 30703-7013 |
| Practice Telephone | 7066959240 |
| Practice Fax Number | 7066959241 |
| Mailing Telephone | 7066027800 |
| Mailing Fax Number | 7068795843 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 2010-00324 | NC | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 27386 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP # | GRP4720 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942467543 | Peter William Henderson | Surgery | 10 Union Sq E Frnt 2l, New York, NY 10003-3314 | 2008-05-21 |
| 1700491024 | Peter Mahlon Henderson | Counselor | 157 Green St, Jamaica Plain, MA 02130-2667 | 2020-09-14 |
| Street Address |
106 HOSPITAL DR SUITE 6 |
| City | CHATSWORTH |
| State | GA |
| Zip Code | 30705-2070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386878411 | Cinthia Fabiola Cox | Nurse Practitioner | 106 Hospital Dr, Suite 2, Chatsworth, GA 30705-2070 | 2009-05-04 |
| 1295992022 | Murray Internal Medicine, PC | Internal Medicine | 106 Hospital Dr, Chatsworth, GA 30705-2070 | 2008-05-20 |
| 1497887442 | Personal Family Care, P.c | Family Medicine | 106 Hospital Dr, Suite 5, Chatsworth, GA 30705-2070 | 2007-03-12 |
| 1356387716 | Immanuel Women's Center, L.l.c | Obstetrics & Gynecology | 106 Hospital Dr, Suite 6, Chatsworth, GA 30705-2070 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821582784 | Kayla Michelle Khan | Dentist | 221 N. 4th Avenue, Chatsworth, GA 30705 | 2018-06-14 |
| 1578079869 | Professional Eye Associates, Inc. | Eyewear Supplier (Equipment, not the service) | 113 West Pine Street, Chatsworth, GA 30705 | 2017-12-21 |
| 1518472778 | Rebecca Annette Lunsford | Case Manager/Care Coordinator | 165 Freedom Way, Chatsworth, GA 30705 | 2017-12-11 |
| 1306214630 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 502 Gi Maddox Parkway, Chatsworth, GA 30705 | 2015-09-03 |
| 1003231416 | Jessica Sanders | Nurse Practitioner | 800 Gi Maddox Pwky, Chatsworth, GA 30705 | 2014-02-20 |
| 1063731560 | Travis Mckie-voerste | Counselor | 96 Terrace Ct, Chatsworth, GA 30705 | 2010-05-24 |
| 1609962521 | Charlie Weichen Fang | Emergency Medicine | 707 Old Ellijay Road, Chatsworth, GA 30705 | 2006-10-05 |
| 1619941689 | Murray County Board of Health | Public Health or Welfare | 709 Dalton-ellijay Highway, Chatsworth, GA 30705 | 2006-02-15 |
| 1780671974 | Trom Enterprises, Inc. | Pharmacy | 101 Murray Plaza, Chatsworth, GA 30705 | 2005-10-03 |
| 1518953785 | Yara Fattouh | Family Medicine | 1111 Hwy 76, Chatsworth, GA 30705 | 2005-09-23 |
| Find all providers in zip 30705 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376537001 | Steven Clark Kennedy | Surgery | 106 Hospital Dr Ste 1, Chatsworth, GA 30705-2070 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043824857 | Oasis Surgical Assistants LLC | Surgery | 170 Blackberry Run Dr, Dallas, GA 30132-1174 | 2020-08-31 |
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1568087260 | Anthony George Campbell | Surgery | 1475 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-09 |
| 1821613431 | America Stephanie Revere | Surgery | Augusta University Medical Center 1120 15th St, Augusta, GA 30912-0001 | 2020-06-09 |
| 1124653456 | Oasis Surgical Associates LLC | Surgery | 800 Kennesaw Ave Nw Ste 130, Marietta, GA 30060-1052 | 2020-03-06 |
| 1063054237 | Stacey M Lowe | Surgery | 146 Wesleyan Way, Macon, GA 31210-4400 | 2019-10-09 |
| 1356982730 | Quinones & Sanchez LLC | Surgery | 1215 Eagles Landing Pkwy Ste 105, Stockbridge, GA 30281-5084 | 2019-10-07 |
| 1891342135 | Chakita Miesha Allen | Surgery | 24 Halyard Dr, Port Wentworth, GA 31407-9755 | 2019-08-21 |
| 1720631088 | 5am P.C. | Surgery | 475 Hansell St Se, Cairo, GA 39828-3071 | 2019-07-16 |
| 1033779152 | Kathryne Holmes | Surgery | 1120 15th St Rm Bi4076, Augusta, GA 30912-0004 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
| City | CHATSWORTH |
| Zip Code | 30705 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.