| Charla V Johnson, PA-C | |
|
950 Eagles Landing Pkwy, Suite 212, Stockbridge, GA 30281-7343 | |
| (404) 307-3062 | |
| Not Available |
| Full Name | Charla V Johnson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 950 Eagles Landing Pkwy, Stockbridge, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033218581 | NPI | - | NPPES |
| 667084523B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 003556 (Georgia) | Primary |
| Entity Name | Tidewater Physicians Multispecialty Group, PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902848294 PECOS PAC ID: 2860398526 Enrollment ID: O20031211000980 |
| Mailing Address | Practice Location Address |
|---|---|
| Charla V Johnson, PA-C 950 Eagles Landing Pkwy, Suite 212, Stockbridge, GA 30281-7343 Ph: (404) 307-3062 | Charla V Johnson, PA-C 950 Eagles Landing Pkwy, Suite 212, Stockbridge, GA 30281-7343 Ph: (404) 307-3062 |
Charles Everett Coppinger, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1492 Hudson Bridge Rd, Stockbridge, GA 30281 Phone: 404-255-1933 Fax: 404-553-9830 |
Briana Stith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1240 Eagles Landing Pkwy Ste 300, Stockbridge, GA 30281 Phone: 770-506-4350 |
James Vincent Edwards, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1240 Eagles Landing Pkwy Ste 300, Stockbridge, GA 30281 Phone: 770-506-4350 Fax: 770-506-9860 |
Isaiah Antonio Boyd, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 226 Willis Dr, Stockbridge, GA 30281 Phone: 770-389-0200 |
Janet Holland, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 175 Country Club Dr, Bldg. 100 Suite C, Stockbridge, GA 30281 Phone: 770-507-1414 Fax: 770-507-5150 |
Elizabeth Matheny Wolfe, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1133 Eagles Landing Pkwy, Stockbridge, GA 30281 Phone: 404-367-3014 |
Mrs. Raketra Rontrese Knight, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 830 Eagles Landing Pkwy Ste 202, Stockbridge, GA 30281 Phone: 707-991-2176 |