Johnson, Roger Dalton

Johnson, Roger Dalton is an individual health care provider with primary practice located at 3000 Saint Matthews Rd , Orangeburg SC 29118-1442. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Johnson, Roger Dalton can be contacted via phone (803) 395-2200.

Contact Information

Primary practice address
3000 Saint Matthews Rd Orangeburg SC 29118-1442
Phone: (803) 395-2200
Fax: (803) 395-2304
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 100263 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 17516 South Carolina

Profile Details

NPI number 1871884742
LBN Legal business name Johnson, Roger Dalton
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2011
Last updated Nov 9th, 2020 - about 4 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 1871884742 NPPES
South Carolina MEDICAID GP2825

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