Johnson, Evelyn Delois
Johnson, Evelyn Delois is an sole proprietor health care provider with primary practice located at 1600 Gloucester St , Brunswick GA 31520-7145. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Johnson, Evelyn Delois can be contacted via phone (912) 265-8080.Contact Information
Primary practice address
1600 Gloucester St
Brunswick GA 31520-7145
Phone: (912) 265-8080
Fax: (912) 265-8513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 039602 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME 60541 | Florida |
Profile Details
| NPI number | 1285781575 |
|---|---|
| LBN Legal business name | Johnson, Evelyn Delois |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jun 9th, 2008 - about 18 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 | 1285781575 | NPPES |
| Georgia | MEDICAID | 00636028B |
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