Individual
DR. DURWOOD M JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1260 HWY 54 W, SUITE 200, FAYETTEVILLE, GA 30214
(770) 461-2101
(770) 460-1292
Mailing address
1260 HWY 54 W, SUITE 200, FAYETTEVILLE, GA 30214
(770) 461-2101
(770) 460-1292
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7973
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000189351B
—
GA
Enumeration date
08/17/2006
Last updated
06/20/2012
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