Johnson, Glen F

Johnson, Glen F is an individual health care provider with primary practice located at 524 Beaumont Rd , Fayetteville NC 28304-4443. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Glen F can be contacted via phone (800) 476-8646.

Contact Information

Primary practice address
524 Beaumont Rd Fayetteville NC 28304-4443
Phone: (800) 476-8646
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 00010366 North Carolina

Profile Details

NPI number 1619971561
LBN Legal business name Johnson, Glen F
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Feb 13th, 2008 - about 18 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 1619971561 NPPES
North Carolina Other P00390009 RAILROAD MEDICARE

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