Individual
CHARLA V JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
950 EAGLES LANDING PKWY, SUITE 212, STOCKBRIDGE, GA 30281-7343
(404) 307-3062
Mailing address
950 EAGLES LANDING PKWY, SUITE 212, STOCKBRIDGE, GA 30281-7343
(404) 307-3062
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003556
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667084523B
—
GA
Enumeration date
09/21/2006
Last updated
08/26/2016
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