Healthcare Provider Details

I. General information

NPI: 1659584480
Provider Name (Legal Business Name): JOHNSON NEUROLOGICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W WARD ST
ASHEBORO NC
27203-5423
US

IV. Provider business mailing address

606 N ELM ST
HIGH POINT NC
27262-4332
US

V. Phone/Fax

Practice location:
  • Phone: 336-629-3500
  • Fax: 336-629-3521
Mailing address:
  • Phone: 336-889-8877
  • Fax: 336-889-7832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH KEITH MILLER
Title or Position: CEO
Credential: MD
Phone: 336-889-8877