MEDICARE: ATLEE ROLLINS JOHNSON III 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
1	208800000X	Urology Physician	33258	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1194709675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATLEE ROLLINS JOHNSON III MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-633-9441
Fax Number	:	704-637-9006

Provider Business Practice Location Address
First Line	:	911 W HENDERSON ST
Second Line	:	STE 110
City	:	SALISBURY
State	:	NC
Zip	:	28144-2736
Country	:	US
Telephone Number	:	704-633-9441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	08/18/2021

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