Individual
SPENCER JACOB JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5629 HWY 21 S, RINCON, GA 31326
(912) 295-2133
Mailing address
5629 HWY 21 S, RINCON, GA 31326-9416
(912) 295-2133
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
81790
GA
Other
Enumeration date
06/21/2016
Last updated
07/03/2019
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