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NPI Code Detail

MEDICARE: TROY EDWIN JOHNSON MD

MEDICARE: TROY EDWIN JOHNSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician45256GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285611053
Entity Type Code : Individual
Provider Name (Legal Business Name) : TROY EDWIN JOHNSON MD
Provider Business Mailing Address
First Line : PO BOX 5779
Second Line :
City : ATHENS
State : GA
Zip : 30604-5779
Country : US
Telephone Number : 706-310-0381
Fax Number : 706-310-0390
Provider Business Practice Location Address
First Line : 5126 HOSPITAL DR NE
Second Line :
City : COVINGTON
State : GA
Zip : 30014-2566
Country : US
Telephone Number : 800-532-6151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 07/20/2022

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