Individual
DR. JAY THOMAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
606 BLACK RIVER RD, GEORGETOWN, SC 29440-3368
(843) 527-7000
(843) 520-8403
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 527-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36493
SC
207P00000X
Emergency Medicine Physician
N6894
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218445901
—
TX
05
—
218445902
—
TX
01
—
P00896831
RAILROAD
TX
Enumeration date
09/05/2007
Last updated
11/21/2025
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