Jackie H Johnson JR. M.D.

NPI 1679707541 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1679707541
Gender Male
Enumeration Date 05/07/2009
Last Updated 06/26/2013
Entity Type Individual
Active Over 7 years ago
Practice Location
3215 SHRINE RD
SUITE #6
BRUNSWICK GA, 31520-4387, US
Phone (912) 267-0565
Fax (912) 262-1169
Business Location
3215 SHRINE RD
SUITE #6
BRUNSWICK GA, 31520-4387, US
Phone (912) 267-0565
Fax (912) 262-1169
Toxanomy
Taxonomy Code 390200000X
License State Virginia
License Number 0116022302
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According to our database, Dr. Jackie H Johnson JR. M.D. NPI is 1679707541, taxonomy code is 390200000X and license number is 0116022302, license state is located at Virginia. Jackie H Johnson JR. M.D. physically located at 3215 Shrine Rd, Brunswick GA, 31520-4387. NPI Number Jackie H Johnson JR. M.D. has the Individual type.

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1679707541 NPI number is provided on an as is basis without warranty of any kind. 1679707541 is maintained by the National Plan & Provider Enumeration System. The contents of Jackie H Johnson JR. M.D. are for informational purposes only.