Individual
MIEK C. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1008 ATLANTA HWY, TRI-COUNTY HEALTH SYSTEM, INC., WARRENTON, GA 30828-0312
(706) 465-3253
(706) 465-3028
Mailing address
3686 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 465-3253
(706) 465-3028
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000471809A
—
GA
Enumeration date
11/12/2010
Last updated
05/22/2019
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