| NPI | 1912288135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E JOHNSON Owner 912-330-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: GA 035071) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |