Individual
ALEX WALKER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1664 RIBAUT RD, PORT ROYAL, SC 29935-1708
(843) 522-8466
Mailing address
125 FURROW LN, LADYS ISLAND, SC 29907-1272
(606) 316-2562
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12871
GA
207W00000X
Ophthalmology Physician
12871
GA
207W00000X
Ophthalmology Physician
Primary
93824
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12871
GEORGIA RESIDENCY TRAINING PERMIT
GA
01
—
93824
SC MEDICAL LICENSE
SC
05
—
938240
—
SC
Enumeration date
06/03/2021
Last updated
08/06/2025
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