Provider Demographics
NPI:1679836704
Name:HENDRIX, JAMES E JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:HENDRIX
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3105
Mailing Address - Country:US
Mailing Address - Phone:662-234-0492
Mailing Address - Fax:
Practice Address - Street 1:417 N 11TH ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3105
Practice Address - Country:US
Practice Address - Phone:662-234-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA036-06736-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies