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Contact Information

STACEY W JOHNSON, MD
509 GORDON AVE
THOMASVILLE, GA31792
 Phone: 229-226-7544
 Fax: 229-226-0314
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for STACEY W JOHNSON · (Female)

NPI # 1376511667
Status Active
Credentials MD
Entity Individual
Enumeration date 03/10/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 041324
  • GA Medicaid 000706439B
  • GA Medicaid 000706439C
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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