Johnson, Earlie T

Johnson, Earlie T is an sole proprietor health care provider with primary practice located at 2580 Henderson Dr , Jacksonville NC 28546-5252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Johnson, Earlie T can be contacted via phone (910) 346-1188.

Contact Information

Primary practice address
2580 Henderson Dr Jacksonville NC 28546-5252
Fax: (910) 346-1275
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 31729 North Carolina

Profile Details

NPI number 1275594079
LBN Legal business name Johnson, Earlie T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2006
Last updated Dec 19th, 2012 - about 14 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 1275594079 NPPES
North Carolina Other 0154H BCBS
North Carolina MEDICAID 890154H BCBS

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