MR. CLYDE D JOHNSON CSA NPI 1821256223

NPI Information

NPI: 1821256223
Provider Name: MR. CLYDE D JOHNSON, CSA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
5881 GLENDRIGE DR NE
SUITE 120
ATLANTA, GA
ZIP 30328
Phone: (404) 303-7703
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MR. Clyde D Johnson, CSA is a surgical physician assistant in Atlanta, GA. MR. Clyde D Johnson, CSA NPI is 1821256223. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5881 GLENDRIGE DR NE
SUITE 120
ATLANTA, GA
ZIP 30328
Phone: (404) 303-7703

The enumeration date for this NPI number is 6/2/2008 and was last updated on 9/22/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	2625-2	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	359555800	OTHER	GEORGIA	DEPT OF LABOR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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