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Individual

DR. RODNEY MARC JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
229 INDUSTRIAL BLVD, DUBLIN, GA 31021-2969
(478) 353-1058
(478) 238-0841
Mailing address
229 INDUSTRIAL BLVD, DUBLIN, GA 31021-2969
(478) 353-1058
(478) 238-0841

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
64841
GA
207R00000X
Internal Medicine Physician
64841
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003110844P
GA
01
202I032517
MEDICARE PTAN
GA
Enumeration date
04/09/2007
Last updated
01/27/2021
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