Individual
PAIGE WILBANKS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 SALUDA POINTE DR, LEXINGTON, SC 29072-7295
(803) 296-7846
(803) 296-9699
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4925
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6366PA
—
SC
Enumeration date
04/12/2023
Last updated
12/20/2023
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