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Individual

MR. MARTIN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
711 CANTON ROAD, SUITE 300, MARIETTA, GA 30060
(678) 741-5000
Mailing address
711 CANTON ROAD, SUITE 300, MARIETTA, GA 30060
(678) 741-5000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300031375A
GA
Enumeration date
06/28/2019
Last updated
10/28/2019
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