Individual
CHARLES E JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3193 HOWELL MILL RD NW, SUITE 306, ATLANTA, GA 30327-2119
(404) 351-7816
(404) 355-3322
Mailing address
3378 VALLEY CIR NW, ATLANTA, GA 30305-1114
(404) 261-4308
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
010204
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00073499B
—
GA
01
—
010204
MEDICAL LICENSE
GA
01
—
581164605
FEDERAL TAX ID
—
Enumeration date
03/07/2007
Last updated
03/07/2023
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