Organization
DR. TERRY D. JOHNSON, P.A.
Active
Other names
Forestview Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY DUANE JOHNSON M.D. (PRESIDENT / CEO)
(864) 590-6561
Entity
Organization
Contact information
Practice address
511 N HIGHWAY 52, MONCKS CORNER, SC 29461-3132
(843) 761-0936
(843) 761-0938
Mailing address
PO BOX 17190, MEDICAL STAFF OFFICE, LAS VEGAS, NV 89114-7190
(702) 560-2916
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7353
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5644
—
SC
Enumeration date
03/16/2011
Last updated
06/03/2011
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