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General NPI Number Information
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NPI Number | 1003320763
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Entity Type | Organization
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Legal Business Name | DR. BEN JOHNSON SERVICES LLC
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 705 BRUCKEN STRASSE BLDG 101
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City | HELEN
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State | GA
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Zip | 30545-3606
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Country | US
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Telephone | 818-331-1844
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14
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City | HELEN
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State | GA
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Zip | 30545-0014
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Country | US
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Telephone | 818-331-1844
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BEN JOHNSON
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Credential | MD, DO, NMD
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Telephone | 818-331-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 23999
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License Number State | GA
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