Individual
JAMES CALVIN JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0001 03423
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7438693
AETNA
—
01
—
B3048
MEDCOST
NC
Enumeration date
12/14/2005
Last updated
05/11/2012
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