Individual
JAMES CALVIN JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
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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