Individual
MARLA GEDDIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
406 MEMORIAL DRIVE EXT, GREER, SC 29651-1818
(864) 877-9066
(864) 848-3291
Mailing address
9 HAWTHORNE PARK CT, GREENVILLE, SC 29615-3194
(864) 603-5600
(864) 603-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1394
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745PA
—
SC
01
—
P00713097
RR MEDICARE
SC
Enumeration date
01/21/2009
Last updated
11/21/2017
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