| Doctor Name: | JERRY STEVEN JOHNSON |
| NPI Number: | 1053392217 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 30487 |
| Business Practice Address: | 116 Mimosa Dr Thomasville, GA - 317926605 |
| Business Phone Number: | 2292282982 |
| Business Fax Number: | 2295518784 |
| Mailing Address: | 116 Mimosa Dr, THOMASVILLE |
| State: | GA |
| Postal Code: | 317926605 |
| Phone Number: | 2292282982 |
| Fax Number: | 2295518784 |
| NPI Enumeration Date: | 11/07/2005 |
| NPI Last Update Date: | 03/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0001X |
| License Number: | 30487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Radiation Oncology |
| Taxonomy Definition: | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |