Organization
MICHAEL R JOHNS PSYD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE BOYER (OFFICE MANAGER)
(478) 477-2220
Entity
Organization
Contact information
Practice address
3678 VINEVILLE AVE, MACON, GA 31204-1868
(478) 477-2220
(478) 477-4455
Mailing address
3678 VINEVILLE AVE, MACON, GA 31204-1868
(478) 477-2220
(478) 477-4455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002759
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
545766522F
—
GA
Enumeration date
06/07/2010
Last updated
06/07/2010
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