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Individual

MR. JOHNNY CAMERON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SURGICAL ASSIST-CERT

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
99-222
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24
SURGICAL FIRST ASSISTANT
TN
Enumeration date
06/28/2013
Last updated
06/28/2013
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