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John Taylor Henson

Internal Medicine

Allopathic & Osteopathic Physicians

1285 Sims St, Gainesville, GA 30501-3851

PECOS Enrollment

This provider is enrolled in PECOS as JOHN HENSON.

Based on the most recent information from CMS, provider John Taylor Henson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1841293958
Provider Type
Individual
Full Name
Henson, John Taylor
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/23/2005
Last Updated
11/16/2022

Contact Information

Practice Location

1285 Sims St, Gainesville, GA 30501-3851

(770) 219-8583

Unlisted Fax

Mailing Location

PO Box 742616, Atlanta, GA 30374-2616

(770) 219-8420

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 29885 Georgia
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 29885 Georgia

Provider Identifiers

ID	Description	Issuer
ID 1640517	Description Other	Issuer CIGNA Georgia

John Taylor Henson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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