| NPI | 1891065504 |
|---|---|
| Former Legal Business Name | CHARLENE JOHNSON, MD |
| Entity Type | Organization |
| Authorized Contact | KATHY ANN DYSON Billing Manager 770-745-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 049655) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |