Individual
CARLA D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
101 OAKLAND CROSSING DR, LEESBURG, GA 31763-7228
(229) 888-4093
(229) 888-4098
Mailing address
101 OAKLAND CROSSING DR, LEESBURG, GA 31763-7228
(229) 888-4093
(229) 888-4098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00600003C
—
GA
Enumeration date
12/19/2006
Last updated
04/06/2016
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