Harley Randall Hendrix (NPI# 1003265836, PAC ID# 3779871207) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1003265836 |
| PAC ID by PECOS | 3779871207 |
| Professional Enrollment ID | I20191014001661 |
| Full Name | Harley Randall Hendrix |
| Organization Legal Name | SJC MEDICAL GROUP, INC |
| Address |
159 W Railroad St Pembroke GA 31321-0190 |
| Phone Number | 9126532897 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7719978105 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110024 | CANDLER HOSPITAL |
| 110043 | ST JOSEPH'S HOSPITAL - SAVANNAH |
| Address | Phone | Organization |
|---|---|---|
| 159 W Railroad St, Pembroke, GA 31321-0190 | 9126532897 | SJC MEDICAL GROUP, INC |
| Organization Legal Name | SJC MEDICAL GROUP, INC |
| Physicians | 53 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew G Marshall | Neurology | Sjc Medical Group, Inc | 410 Mall Blvd E, Savannah, GA 31406-4869 |
| Aaron Webb | Nurse Practitioner | Sjc Medical Group, Inc | 423 S Columbia Ave, Rincon, GA 31326-9080 |
| David Orlando Caraballo | Physician Assistant | Sjc Medical Group, Inc | 10 Oak Forest Rd C, Bluffton, SC 29910-4974 |
| Keith A Rouse Sr. | Podiatry | Sjc Medical Group, Inc | 310 Eisenhower Dr, Bldg 7a, Savannah, GA 31406-2688 |
| Russell William Lake | Family Medicine | Sjc Medical Group, Inc | 105 Grand Central Blvd, Suite 107, Pooler, GA 31322-4148 |
| Jose M Rendon-garcia | Internal Medicine | Sjc Medical Group, Inc | 11705 Mercy Blvd, Savannah, GA 31419-1711 |
| Marianne M Fleming | Internal Medicine | Sjc Medical Group, Inc | 836 E, 65th Suite 30, Savannah, GA 31405 |
| Richard J Barrett | Internal Medicine | Sjc Medical Group, Inc | 102 Bryan Woods Rd, Savannah, GA 31410-1225 |
| Frederic C Spector | Podiatry | Sjc Medical Group, Inc | 352 Commercial Dr, Savannah, GA 31406-3616 |
| Suzanne M Anderson | Internal Medicine | Sjc Medical Group, Inc | 602 E 72nd St, Savannah, GA 31405-4913 |
| Street Address |
159 W RAILROAD ST |
| City | PEMBROKE |
| State | GA |
| Zip | 31321-0190 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa U Cayton | Nurse Practitioner | Sjc Medical Group, Inc | 159 W Railroad St, Pembroke, GA 31321-0190 |
| Jason Hollis | Family Practice | Sjc Medical Group, Inc | 159 W Railroad St, Pembroke, GA 31321-0190 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael A Register | Family Medicine | 244 Ledford St, Pembroke, GA 31321-4587 | |
| Nacondus G Gamble | Optometry | 175 S Railroad St, Pembroke, GA 31321-5744 |
| City | PEMBROKE |
| Zip Code | 31321 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PEMBROKE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Harley Randall Hendrix.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.