Individual
JAY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 REDMOND RD NW, ROME, GA 30165-1415
(706) 291-0291
Mailing address
PO BOX 162972, ATLANTA, GA 30321-2972
(800) 443-3672
(865) 560-7310
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
030326
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003399385F
—
GA
01
—
930060783
RRGA
GA
Enumeration date
06/16/2006
Last updated
06/23/2008
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