Organization
MILES DAVID JOHNSON, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILES DAVID JOHNSON M. D. (CEO)
(404) 664-4578
Entity
Organization
Contact information
Practice address
150 FIDDLERS RDG, FAYETTEVILLE, GA 30214-2684
(404) 664-4578
(770) 991-5012
Mailing address
150 FIDDLERS RDG, FAYETTEVILLE, GA 30214-2684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0622729N
—
GA
Enumeration date
03/02/2016
Last updated
03/03/2016
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