| Doctor Name: | SIDNEY P JOHNSON |
| NPI Number: | 1992773626 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | 10971 |
| Business Practice Address: | 11 Johnson St Hazlehurst, GA - 315396243 |
| Business Phone Number: | 9123752521 |
| Business Fax Number: | 9123752409 |
| Mailing Address: | Po Box 787, HAZLEHURST |
| State: | GA |
| Postal Code: | 315390787 |
| Phone Number: | 9123752521 |
| Fax Number: | 9123752409 |
| NPI Enumeration Date: | 03/09/2006 |
| NPI Last Update Date: | 10/22/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 10971 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |