Robert E Johnson (NPI# 1093887820, PAC ID# 2567424997) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1093887820 |
| PAC ID by PECOS | 2567424997 |
| Professional Enrollment ID | I20041028000720 |
| Full Name | Robert E Johnson |
| Organization Legal Name | VIDALIA ENT ASSOCIATES, LLC |
| Address |
1707 Meadows Ln C Vidalia GA 30474-7201 |
| Phone Number | 9125373384 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1990 |
| Primary Specialty | OTOLARYNGOLOGY |
| Secondary Specialties | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 4688753791 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110128 | MEADOWS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1707 Meadows Ln C, Vidalia, GA 30474-7201 | 9125373384 | VIDALIA ENT ASSOCIATES, LLC |
| Organization Legal Name | VIDALIA ENT ASSOCIATES, LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald W Williams | Otolaryngology | Vidalia Ent Associates, LLC | 1707 Meadows Ln C, Vidalia, GA 30474-7201 |
| Amber Joyner | Nurse Practitioner | Vidalia Ent Associates, LLC | 1707 Meadows Ln C, Vidalia, GA 30474-7201 |
| Street Address |
1707 MEADOWS LN C |
| City | VIDALIA |
| State | GA |
| Zip | 30474-7201 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald W Williams | Otolaryngology | Vidalia Ent Associates, LLC | 1707 Meadows Ln C, Vidalia, GA 30474-7201 |
| Amber Joyner | Nurse Practitioner | Vidalia Ent Associates, LLC | 1707 Meadows Ln C, Vidalia, GA 30474-7201 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Casey Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Karen Pamela Mcneely | Nurse Practitioner | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| David H Paine | Internal Medicine | 1006 A Mt Vernon Rd, Vidalia, GA 30474 | |
| Walter J Revell Jr. | General Surgery | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Archie J Champion | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Letty Revell Peterson | Dermatology | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Charles M Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Richard M Proenza | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Paul J Giles | Cardiovascular Disease (cardiology) | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Robert Andrew Bell | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Find all physicians in zip 30474 | |||
| City | VIDALIA |
| Zip Code | 30474 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | VIDALIA + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Robert E Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.