Johnson, Glen F
Johnson, Glen F is an individual health care provider with primary practice located at 524 Beaumont Rd , Fayetteville NC 28304-4443. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Glen F can be contacted via phone (800) 476-8646.Contact Information
Primary practice address
524 Beaumont Rd
Fayetteville NC 28304-4443
Phone: (800) 476-8646
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 00010366 | North Carolina |
Profile Details
| NPI number | 1619971561 |
|---|---|
| LBN Legal business name | Johnson, Glen F |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Feb 13th, 2008 - about 17 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 | 1619971561 | NPPES |
| North Carolina | Other | P00390009 | RAILROAD MEDICARE |
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