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NPI Code Detail

MEDICARE: BARBARA LYNN JOHNSON DDS

MEDICARE: BARBARA LYNN JOHNSON DDS
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
1122300000XDentistDN014420GA

General Provider Information

NPI Number : 1952665663
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA LYNN JOHNSON DDS
Provider Business Mailing Address
First Line : 2607 GILLIONVILLE RD
Second Line :
City : ALBANY
State : GA
Zip : 31707-3003
Country : US
Telephone Number : 229-883-9001
Fax Number :
Provider Business Practice Location Address
First Line : 2607 GILLIONVILLE RD
Second Line :
City : ALBANY
State : GA
Zip : 31707-3003
Country : US
Telephone Number : 229-883-9001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2012
Last Update Date : 10/30/2015

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