Individual
DR. ANTHONY P JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4120 N VALDOSTA RD STE A, VALDOSTA, GA 31602-4973
(229) 244-2068
(229) 244-2850
Mailing address
4120 N VALDOSTA RD STE A, VALDOSTA, GA 31602-4973
(229) 244-2068
(229) 244-2850
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
21922
SC
207W00000X
Ophthalmology Physician
Primary
26877
GA
207W00000X
Ophthalmology Physician
F9622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00441152A
—
GA
05
—
110025
—
SC
01
—
2802730003
CIGNA PROVIDER NUMBER
SC
01
—
4232660
AETNA PROVIDER NUMBER
SC
05
—
890159W
—
NC
01
—
P00134990
MEDICARE RAILROAD
SC
Enumeration date
01/26/2006
Last updated
09/10/2021
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