Johnson, Durwood M

Johnson, Durwood M is an sole proprietor health care provider with primary practice located at 1260 Hwy 54 W Suite 200, Fayetteville GA 30214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Johnson, Durwood M can be contacted via phone (770) 461-2101.

Contact Information

Primary practice address
1260 Hwy 54 W Suite 200 Fayetteville GA 30214
Phone: (770) 461-2101
Fax: (770) 460-1292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 7973 Georgia

Profile Details

NPI number 1861505141
LBN Legal business name Johnson, Durwood M
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Jun 20th, 2012 - about 12 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 1861505141 NPPES
Georgia MEDICAID 000189351B

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