| Organization Name: | JOHNSON MEDICAL AND AESTHETICS |
| NPI Number: | 1659748333 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM JOHNSON (CHIEF OFFICER) |
| Mailing Address: | 5500 Frederica Rd Suite 2202 Saint Simons Island |
| State: | GA US |
| Postal Code: | 315229710 |
| Phone Number: | 9125801551 |
| Fax Number: | |
| NPI Enumeration Date: | 08/28/2015 |
| NPI Last Update Date: | 08/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 064997 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |