Provider Demographics
NPI:1821035627
Name:HEARN, HENRY B IV (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:B
Last Name:HEARN
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2047
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-2047
Mailing Address - Country:US
Mailing Address - Phone:864-512-4500
Mailing Address - Fax:864-512-4505
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 4500
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-4500
Practice Address - Fax:864-512-4505
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC9038207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC009038Medicaid
SC7111Medicare PIN
D99352Medicare UPIN