Individual
DR. OLIVIA MARIE GRANILLO JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 380-4072
Mailing address
1700 MEDICAL CENTER PKWY, MURFREESBORO, TN 37129-2245
(615) 396-4694
(615) 396-3751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48469
TN
208000000X
Pediatrics Physician
48469
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3710089
—
TN
Enumeration date
05/20/2008
Last updated
08/09/2022
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