Individual
MR. CASEY LOUIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
744 MIDDLE CREEK RD STE 114, SEVIERVILLE, TN 37862-5036
(865) 446-9575
Mailing address
744 MIDDLE CREEK RD STE 114, SEVIERVILLE, TN 37862-5036
(865) 446-9575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2638
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q019055
—
TN
Enumeration date
10/01/2014
Last updated
03/21/2024
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