Individual
COLTON TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 450-1397
(803) 259-3250
Mailing address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 450-1397
(803) 259-3250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11020581A
IN
207Q00000X
Family Medicine Physician
112270
GA
207Q00000X
Family Medicine Physician
Primary
88582
SC
Other
Enumeration date
06/10/2019
Last updated
05/07/2026
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