Johnson, Evelyn Delois

Johnson, Evelyn Delois is an sole proprietor health care provider with primary practice located at 1600 Gloucester St , Brunswick GA 31520-7145. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Johnson, Evelyn Delois can be contacted via phone (912) 265-8080.

Contact Information

Primary practice address
1600 Gloucester St Brunswick GA 31520-7145
Phone: (912) 265-8080
Fax: (912) 265-8513
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 039602 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME 60541 Florida

Profile Details

NPI number 1285781575
LBN Legal business name Johnson, Evelyn Delois
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 5th, 2007
Last updated Jun 9th, 2008 - about 16 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 1285781575 NPPES
Georgia MEDICAID 00636028B

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