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Individual

DR. JOE H JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2409 N PATTERSON ST, SUITE 230, VALDOSTA, GA 31602-2512
(229) 259-4369
(229) 433-6513
Mailing address
2409 N PATTERSON ST, SUITE 230, VALDOSTA, GA 31602-2512
(229) 259-4369
(229) 433-6513

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
025621
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00391058F
GA
01
2501248
BLUE CROSS HMO
GA
01
5569443
BLUE CROSS PPO
GA
01
770002553
RAILROAD
GA
Enumeration date
06/15/2006
Last updated
09/09/2014
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