Provider Demographics
NPI:1588692727
Name:GARRARD, HENRY G (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:G
Last Name:GARRARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:BLDG 600 STE B
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-549-3426
Mailing Address - Fax:706-549-3432
Practice Address - Street 1:1500 OGLETHORPE AVE
Practice Address - Street 2:BLDG 600 STE B
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-549-3426
Practice Address - Fax:706-549-3432
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-06-25
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Provider Licenses
StateLicense IDTaxonomies
GA052568208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA902553513AMedicaid