Johnson, Eric Gordon

Johnson, Eric Gordon is an individual health care provider with primary practice located at 200 S Herlong Ave Suite B, Rock Hill SC 29732-3399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Eric Gordon can be contacted via phone (803) 325-1770.

Contact Information

Primary practice address
200 S Herlong Ave Suite B Rock Hill SC 29732-3399
Phone: (803) 325-1770
Fax: (803) 325-1790
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9691 South Carolina

Profile Details

NPI number 1871550558
LBN Legal business name Johnson, Eric Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Sep 26th, 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 1871550558 NPPES
North Carolina MEDICAID 890631K
North Carolina MEDICAID 096915

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