Individual
DR. JASON MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 E WOOD ST, SUITE 202, SPARTANBURG, SC 29303-3004
(864) 560-7070
(864) 560-7033
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
O624
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006246
—
SC
05
—
5918438
—
NC
01
—
P00980724
RAILROAD MEDICARE
SC
Enumeration date
09/15/2006
Last updated
08/28/2013
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