Dr Cody Tyler Johnson, DO | |
800 N Fant St, Anderson, SC 29621-5708 | |
(864) 512-1000 | |
Not Available |
Full Name | Dr Cody Tyler Johnson |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 800 N Fant St, Anderson, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558711911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 5101022301 (Michigan) | Secondary |
207P00000X | Emergency Medicine | 83087 (South Carolina) | Primary |
Entity Name | Ich Er Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174002059 PECOS PAC ID: 2860744331 Enrollment ID: O20181010003402 |
Mailing Address | Practice Location Address |
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Dr Cody Tyler Johnson, DO 18 Appleton Ln, Mauldin, SC 29662-3415 Ph: (616) 826-0506 | Dr Cody Tyler Johnson, DO 800 N Fant St, Anderson, SC 29621-5708 Ph: (864) 512-1000 |
James E. Reese, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-512-1335 | |
Michael Clarke, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-512-1000 | |
Dr. Kevin Matthew Summers, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 863-899-6081 | |
Dr. Zachary Hall Conn, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-607-3835 | |
David Scott Turner, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-512-1335 | |
Joseph Daniel Cox, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-512-1000 | |
Anthony W. Rekito, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 N Fant St, Anderson, SC 29621 Phone: 864-512-1335 |