Johnson, Miles D

Johnson, Miles D is an individual health care provider with primary practice located at 150 Fiddlers Rdg , Fayetteville GA 30214-2684. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Miles D can be contacted via phone (404) 664-4578.

Contact Information

Primary practice address
150 Fiddlers Rdg Fayetteville GA 30214-2684
Phone: (404) 664-4578
Fax: (770) 991-5012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 038817 Georgia

Profile Details

NPI number 1568419844
LBN Legal business name Johnson, Miles D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Apr 15th, 2020 - about 5 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 1568419844 NPPES
Georgia MEDICAID 00622729G

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