Individual
RAY EDWARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Mailing address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
017835
GA
207RI0011X
Interventional Cardiology Physician
Primary
27647
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00222384A
—
GA
01
—
2089836
AETNA HMO
GA
01
—
237923
BCBS
GA
01
—
2671375-002
CIGNA
GA
01
—
4115000
AETNA PPO
GA
05
—
G17835
—
SC
Enumeration date
07/17/2006
Last updated
12/27/2023
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