Individual
MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
289 GRAYSON HWY STE 2A, LAWRENCEVILLE, GA 30046-5726
(770) 771-5560
(678) 344-8600
Mailing address
2878 FIVE FORKS TRICKUM RD, STE 2A, LAWRENCEVILLE, GA 30044-5896
(678) 344-8700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1032237
CO
Other
Enumeration date
10/03/2006
Last updated
03/25/2019
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