JACK DAVID HENEISEN

RINCON, GA
NPI1447310115
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: GA  022780)
Enumeration Date2006-12-11
Last Update Date2007-07-08
Business Address
Dr. JACK DAVID HENEISEN M.D.
1214 N COLUMBIA AVE. UNIT D
RINCON, GA 31326
Phone number: 912-826-2132
Mailing Address
Dr. JACK DAVID HENEISEN M.D.
PO BOX 2089
RINCON, GA 31326-2089
Phone number: 912-826-2132
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