Individual
WILLIAM BRADFORD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606
(706) 207-4621
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
79340
GA
Other
Enumeration date
06/25/2014
Last updated
07/25/2018
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