Individual
LYNN R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
9701780
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
9701780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11578
BCBS OF NC
NC
01
—
1508835091
TRICARE
NC
01
—
195409
MEDCOST
NC
05
—
8911578
—
NC
01
—
P00303989
RAILROAD MEDICARE
NC
Enumeration date
03/16/2006
Last updated
04/07/2021
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