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Individual

HARRY F JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
550 TWIN CITIES BLVD, SUITE A, NICEVILLE, FL 32578-1067
(850) 729-1444
(850) 729-0300
Mailing address
550 TWIN CITIES BLVD, SUITE A, NICEVILLE, FL 32578-1067
(850) 729-1444
(850) 729-0300

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
565
TN
363AM0700X
Medical Physician Assistant
Primary
9104154
FL

Other

Enumeration date
06/08/2006
Last updated
06/11/2012
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