| Olivia Johnson, MD | |
|
864 Black Creek Rd, Four Oaks, NC 27524-8314 | |
| (919) 936-3148 | |
| (919) 936-2900 |
| Full Name | Olivia Johnson |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 864 Black Creek Rd, Four Oaks, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801454244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 94-09933 (Kansas) | Secondary |
| 207Q00000X | Family Medicine | 202302334 (North Carolina) | Primary |
| Entity Name | Raleigh Durham Medical Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194828145 PECOS PAC ID: 2365409588 Enrollment ID: O20041220000155 |
| Mailing Address | Practice Location Address |
|---|---|
| Olivia Johnson, MD 864 Black Creek Rd, Four Oaks, NC 27524-8314 Ph: (919) 936-3148 | Olivia Johnson, MD 864 Black Creek Rd, Four Oaks, NC 27524-8314 Ph: (919) 936-3148 |
Dr. Stanley Rudolph Watson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 864 Black Creek Rd, Four Oaks, NC 27524 Phone: 919-963-3148 Fax: 919-963-2900 | |
Monica Ann Selak, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 864 Black Creek Rd, Four Oaks, NC 27524 Phone: 919-963-3148 Fax: 919-963-2900 |