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NPI Code Detail

MEDICARE: ELIZABETH JANE JOHNSON M.D.

MEDICARE: ELIZABETH JANE JOHNSON M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianV3775TX
3207P00000XEmergency Medicine Physician91498SC
4207P00000XEmergency Medicine Physician25MA10344400NJ

General Provider Information

NPI Number : 1982043725
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JANE JOHNSON M.D.
Provider Business Mailing Address
First Line : PO BOX 743070
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3070
Country : US
Telephone Number : 864-560-4304
Fax Number : 864-560-4413
Provider Business Practice Location Address
First Line : 101 E WOOD ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-3040
Country : US
Telephone Number : 864-560-7025
Fax Number : 864-560-7388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2013
Last Update Date : 05/28/2026

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