Individual
CLANFORD LYONEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1305 S SUBER RD, GREER, SC 29650-0944
(864) 989-4609
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200400688
NC
207Q00000X
Family Medicine Physician
Primary
25112
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904663
—
NC
01
—
P00329935
RAILROAD MEDICARE
NC
Enumeration date
03/29/2006
Last updated
07/29/2015
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