Sidney P Johnson, M.D. P.C

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

10971 Issued in GA

Legal business name

SIDNEY P JOHNSON, M.D. P.C

Practice address

11 Johnson St
Hazlehurst, GA 31539-6243

Phone

(912) 375-2521

NPI assigned

Oct 23, 2007

Last updated

Oct 23, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Phyllis Griffin

Title

Insurance Manager

Phone

(912) 375-2521

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1396934659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315390787",
            "telephone_number": "912-375-2521",
            "fax_number": "912-375-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHNSON ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396243",
            "telephone_number": "912-375-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY P JOHNSON, M.D. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "912-375-2521",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "10971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112912A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerri-Ann Rowell
• Rural Urgent Care LLC (MainStreet Family Care)
• Scott J Waguespack MD/Family Healthcare
• Sara Ellen Sears
• David L Shumans, M.D.
• Southeast Georgia Homehealth Care Inc.
• Southern Eyecare, P.C.
• Dana Vanessa Stone, FNP
• Ethan Stone
• Sunbridge Jeff Davis Healthcare LLC (Hazelhurst Court Care and Rehabilitation Center)

• General Practice Physician in Hazlehurst, GA
• Providers in Hazlehurst, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.