Individual
JEREMY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1130 N CHURCH ST STE 100, GREENSBORO, NC 27401-1041
(336) 235-3105
(336) 375-2314
Mailing address
1130 N CHURCH ST STE 100, GREENSBORO, NC 27401-1041
(336) 235-3105
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-09785
NC
363A00000X
Physician Assistant
C05352
MD
Other
Enumeration date
03/25/2014
Last updated
07/07/2021
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