Healthcare Provider Details

I. General information

NPI: 1639141674
Provider Name (Legal Business Name): TERRANCE PERCELL JOHNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/25/2023
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 PINEYWOOD RD
THOMASVILLE NC
27360-3438
US

IV. Provider business mailing address

PO BOX 751803
CHARLOTTE NC
28275-1803
US

V. Phone/Fax

Practice location:
  • Phone: 336-475-8121
  • Fax: 336-475-5377
Mailing address:
  • Phone: 336-475-8121
  • Fax: 336-475-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9401424
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: