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Individual

DR. CANDACE J JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
225 COUNTRY CLUB DR STE 200, STOCKBRIDGE, GA 30281-7302
(678) 782-7137
(678) 782-7135
Mailing address
225 COUNTRY CLUB DR STE 200, STOCKBRIDGE, GA 30281-7302
(678) 782-7137
(678) 782-7135

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
50389
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000917782C
GA
Enumeration date
11/23/2005
Last updated
01/03/2021
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