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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821256223 NPPES
Georgia Other 359555800 DEPT OF LABOR

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