Provider Demographics
NPI:1891893012
Name:JOHN C HENDRIX, MD, PC
Entity Type:Organization
Organization Name:JOHN C HENDRIX, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:334-834-3059
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-834-3059
Mailing Address - Fax:334-834-4260
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:SUITE 402
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-834-3059
Practice Address - Fax:334-834-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00009539207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty