Johnson, Clanford Lyonel

Johnson, Clanford Lyonel is an individual health care provider with primary practice located at 1305 S Suber Rd , Greer SC 29650-0944. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Clanford Lyonel can be contacted via phone (864) 989-4609.

Contact Information

Primary practice address
1305 S Suber Rd Greer SC 29650-0944
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 200400688 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25112 South Carolina

Profile Details

NPI number 1750342879
LBN Legal business name Johnson, Clanford Lyonel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jul 29th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750342879 NPPES
North Carolina MEDICAID 5904663
North Carolina Other P00329935

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