Individual
MICHAEL OLTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
377 W PIKE ST # A3-2, LAWRENCEVILLE, GA 30046-4881
(470) 461-7031
(770) 502-6820
Mailing address
377 W PIKE ST # A3-2, LAWRENCEVILLE, GA 30046-4881
(470) 461-7031
(770) 502-6820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
021943
NY
363A00000X
Physician Assistant
Primary
11074
GA
Other
Enumeration date
04/09/2018
Last updated
05/09/2023
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