Provider Demographics
NPI:1366647869
Name:HENSCHEN, GARY MAYES (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:MAYES
Last Name:HENSCHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:45 BATTLE RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2453
Mailing Address - Country:US
Mailing Address - Phone:678-319-3705
Mailing Address - Fax:770-753-2290
Practice Address - Street 1:45 BATTLE RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2453
Practice Address - Country:US
Practice Address - Phone:678-319-3705
Practice Address - Fax:770-753-2290
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0413082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry