Individual
ANITA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
120 N MEDICAL PKWY BLDG 100, SUITE 201, WOODSTOCK, GA 30189-7062
(678) 445-0976
Mailing address
PO BOX 5042, CANTON, GA 30114-0250
(678) 445-0976
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
53464
GA
Other
Enumeration date
01/11/2007
Last updated
12/31/2009
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