| NPI | 1972725216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DAVID JOHNSON Practice Owner/Physician 229-391-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 28796) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-05-08 |