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Individual

DR. LESTER R. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2841 N PATTERSON ST, VALDOSTA, GA 31602-1890
(229) 316-2619
Mailing address
2841 N PATTERSON ST, VALDOSTA, GA 31602-1890

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
026329
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4119544
BLUE CROSS
TN
05
PENDING
TN
Enumeration date
06/16/2006
Last updated
04/09/2013
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