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Individual

ERIC GORDON JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 S HERLONG AVE, SUITE B, ROCK HILL, SC 29732-3399
(803) 325-1770
(803) 325-1790
Mailing address
200 S HERLONG AVE, SUITE B, ROCK HILL, SC 29732-3399
(803) 325-1770
(803) 325-1790

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9691
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096915
SC
05
890631K
NC
Enumeration date
04/27/2006
Last updated
09/26/2012
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