Organization
FAMILY MEDICINE OF BAXLEY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVELYN J JOHNSON MD (OWNER)
(912) 705-1227
Entity
Organization
Contact information
Practice address
408 S MAIN ST, BAXLEY, GA 31513-0184
(912) 705-1227
(912) 705-0673
Mailing address
251 RICARDO ST, BAXLEY, GA 31513-7057
(912) 705-1227
(912) 705-0673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056182
GA
Other
Enumeration date
12/02/2017
Last updated
12/02/2017
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