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NPI Code Detail

MEDICARE: DR. GERALD PALMER JOHNSON DMD

MEDICARE: DR. GERALD PALMER JOHNSON DMD
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
11223G0001XGeneral Practice Dentistry3220SC

Other Identifiers

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

General Provider Information

NPI Number : 1609887835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD PALMER JOHNSON DMD
Provider Business Mailing Address
First Line : 312 NEW TARLETON WAY
Second Line :
City : GREER
State : SC
Zip : 29650-3249
Country : US
Telephone Number : 843-364-3677
Fax Number :
Provider Business Practice Location Address
First Line : 975 W FARIS RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4241
Country : US
Telephone Number : 864-729-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 04/15/2025

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