Individual
MRS. TATIA FORD JOHNSON
Active
Individual
MRS. TATIA FORD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0002501
MD
363AM0700X
Medical Physician Assistant
M002916L
PA
Other
Enumeration date
09/11/2008
Last updated
10/14/2010
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