Miles David Johnson, Md Pc | |
150 Fiddlers Rdg Fayetteville GA 30214-2684 | |
(404) 664-4578 | |
(770) 991-5012 |
Full Name | Miles David Johnson, Md Pc |
---|---|
Speciality | Family Medicine |
Location | 150 Fiddlers Rdg, Fayetteville, Georgia |
Authorized Official Name and Position | Miles David Johnson (CEO) |
Authorized Official Contact | 4046644578 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Miles David Johnson, Md Pc 150 Fiddlers Rdg Fayetteville GA 30214-2684 Ph: () - | Miles David Johnson, Md Pc 150 Fiddlers Rdg Fayetteville GA 30214-2684 Ph: (404) 664-4578 |
NPI Number | 1801256946 |
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Provider Enumeration Date | 03/02/2016 |
Last Update Date | 03/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801256946 | NPI | - | NPPES |
0622729N | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Georgia) | Primary |
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