Jack Heneisen, M.D

NPI 1447310115 · on the registry since 2006 · sole proprietor

Practice

Address: 1214 N Columbia Ave.
Unit D
Rincon, GA 31326
Phone: (912) 826-2132
Fax: (912) 826-2141
Organisation at this address: Curtis V. Cooper Primary Health Care, Inc.
Salon Nevaeh Certified Hair Replacement Specialist , Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 207Q00000X
207Q00000X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia