Johnson, Clyde D
Johnson, Clyde D is an sole proprietor health care provider with primary practice located at 5881 Glendrige Dr Ne Suite 120, Atlanta GA 30328. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Johnson, Clyde D can be contacted via phone (404) 303-7703.Contact Information
Primary practice address
5881 Glendrige Dr Ne Suite 120
Atlanta GA 30328
Phone: (404) 303-7703
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2625-2 | Georgia |
Profile Details
| NPI number | 1821256223 |
|---|---|
| LBN Legal business name | Johnson, Clyde D |
| Credentials | CSA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2008 |
| Last updated | Sep 22nd, 2017 - about 9 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 | 1821256223 | NPPES |
| Georgia | Other | 359555800 | DEPT OF LABOR |
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