Individual
DR. JEREMY CLYDE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
214 18TH ST SE, HICKORY, NC 28602-1363
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
9901552
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
9901552
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89137X6
—
NC
Enumeration date
06/02/2006
Last updated
03/07/2023
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