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Individual

OLGA KHODAKOVA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1606 MORGANTON RD, FAYETTEVILLE, NC 28305-4738
(910) 484-3121
(910) 221-2036
Mailing address
1606 MORGANTON RD, FAYETTEVILLE, NC 28305-4738
(910) 484-3121
(910) 221-2036

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2013-00053
NC
208000000X
Pediatrics Physician
8278611-1205
UT

Other

Enumeration date
06/15/2009
Last updated
02/04/2013
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