Individual
DR. CODY TYLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1000
Mailing address
18 APPLETON LN, MAULDIN, SC 29662-3415
(616) 826-0506
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101022301
MI
207P00000X
Emergency Medicine Physician
Primary
83087
SC
Other
Enumeration date
06/16/2016
Last updated
06/05/2020
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