Individual
ANTHONY WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3207 COUNTRY CLUB RD, VALDOSTA, GA 31605-1029
(229) 242-8480
(229) 242-0070
Mailing address
3207 COUNTRY CLUB RD, VALDOSTA, GA 31605-1029
(229) 242-8480
(229) 242-0070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
005433
GA
Other
Enumeration date
05/23/2012
Last updated
02/23/2016
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