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Organization
DR. TERRY D. JOHNSON, P.A.
Active
Organization
DR. TERRY D. JOHNSON, P.A.
Active
Other names
Forestview Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY DUANE JOHNSON M.D. (PRESIDENT / CEO)
(864) 590-6561
Entity
Organization
Contact information
Practice address
511 N HIGHWAY 52, MONCKS CORNER, SC 29461-3132
(843) 761-0936
(843) 761-0938
Mailing address
PO BOX 17190, MEDICAL STAFF OFFICE, LAS VEGAS, NV 89114-7190
(702) 560-2916
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7353
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5644
—
SC
Enumeration date
03/16/2011
Last updated
06/03/2011
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