Johnson, Candace J
Johnson, Candace J is an sole proprietor health care provider with primary practice located at 225 Country Club Dr Ste 200 , Stockbridge GA 30281-7302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Johnson, Candace J can be contacted via phone (678) 782-7137.Contact Information
Primary practice address
225 Country Club Dr Ste 200
Stockbridge GA 30281-7302
Phone: (678) 782-7137
Fax: (678) 782-7135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 50389 | Georgia |
Profile Details
| NPI number | 1730162702 |
|---|---|
| LBN Legal business name | Johnson, Candace J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Jan 3rd, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730162702 | NPPES |
| Georgia | MEDICAID | 000917782C |
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