| Donovan Eric Johnson, MD | |
|
115 Lee Byrd Road, Loganville, GA 30052-6476 | |
| (770) 554-4717 | |
| Not Available |
| Full Name | Donovan Eric Johnson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 12 Years |
| Location | 115 Lee Byrd Road, Loganville, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316173875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 55859 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | 007034 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Amedisys Home Health Of Covington | Covington, GA | Home health agency |
| Central Home Health Care, An Amedisys Company | Tucker, GA | Home health agency |
| Eastside Medical Center | Snellville, GA | Hospital |
| Northside Hospital Gwinnett | Lawrenceville, GA | Hospital |
| Northside Hospital Forsyth | Cumming, GA | Hospital |
| Piedmont Walton Hospital | Monroe, GA | Hospital |
| Piedmont Athens Regional Medical Center | Athens, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gwinnett Physician Group, Llc | 9133211139 | 116 |
| Northside Urgent Care Holding Llc | 4587984695 | 80 |
| Entity Name | Gwinnett Physician Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578574661 PECOS PAC ID: 9133211139 Enrollment ID: O20070822001035 |
| Entity Name | Health Choice Urgent Care, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679948988 PECOS PAC ID: 1951690213 Enrollment ID: O20160510001919 |
| Mailing Address | Practice Location Address |
|---|---|
| Donovan Eric Johnson, MD 115 Lee Byrd Road, Loganville, GA 30052 Ph: (770) 554-4717 | Donovan Eric Johnson, MD 115 Lee Byrd Road, Loganville, GA 30052-6476 Ph: (770) 554-4717 |