Individual
DONOVAN ERIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 LEE BYRD ROAD, LOGANVILLE, GA 30052-6476
(770) 554-4717
Mailing address
115 LEE BYRD ROAD, LOGANVILLE, GA 30052
(770) 554-4717
(770) 554-4681
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
55859
TN
207Q00000X
Family Medicine Physician
Primary
007034
GA
Other
Enumeration date
06/10/2009
Last updated
10/13/2020
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