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NPI 1083136337

NPI 1083136337 : BUFFY BOWERS JOHNSON : MACON, GA

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General NPI Number Information
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    NPI Number           |    1083136337
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    Entity Type          |    Individual 
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    Provider Name        |    BUFFY BOWERS JOHNSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/07/2017
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    Last Update Date     |    07/07/2017
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Provider Practice Location Address
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    Address Line         |    6035 ZEBULON RD 
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    City                 |    MACON
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    State                |    GA
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    Zip                  |    31210-2032
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    Country              |    US
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    Telephone            |    478-757-2027
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    Fax                  |    478-757-0352
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Provider Business Mailing Address
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    Address Line         |    112 BELLEWOOD CT 
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    City                 |    MACON
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    State                |    GA
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    Zip                  |    31210-7544
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    Country              |    US
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    Telephone            |    478-475-1864
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    RPH019062
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    License Number State |    GA
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