Individual
TERRANCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST # HB-4000, AUGUSTA, GA 30912-0004
(706) 721-3159
Mailing address
3945 BOLTON ST, AUGUSTA, GA 30909-9562
(706) 829-4972
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12853
GA
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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