Provider Demographics
NPI:1598185159
Name:HENDRICKS, JHODY-ANN (MD)
Entity Type:Individual
Prefix:
First Name:JHODY-ANN
Middle Name:
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2500
Mailing Address - Country:US
Mailing Address - Phone:270-821-1229
Mailing Address - Fax:270-821-1220
Practice Address - Street 1:1405 CLIFTON RD NE
Practice Address - Street 2:CHILDREN'S HELATH CARE ATLANTA
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1060
Practice Address - Country:US
Practice Address - Phone:404-785-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA760092080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty