Lancaster, Micah Henderson

Lancaster, Micah Henderson is an individual health care provider with primary practice located at 1111 Glynco Pkwy Building 1, Suite 20, Brunswick GA 31525-7921. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Lancaster, Micah Henderson can be contacted via phone (912) 262-1801.

Contact Information

Primary practice address
1111 Glynco Pkwy Building 1, Suite 20 Brunswick GA 31525-7921
Phone: (912) 262-1801
Fax: (912) 264-6262
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 006295 Georgia

Profile Details

NPI number 1285917401
LBN Legal business name Lancaster, Micah Henderson
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2011
Last updated Mar 12th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285917401 NPPES
Georgia Other 006295 GEORGIA LICENSE
Georgia MEDICAID 003116432 GEORGIA LICENSE
Georgia MEDICAID 003116443 GEORGIA LICENSE

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