Provider Demographics
NPI:1114921954
Name:JOHNSON NEUROLOGICAL CLINIC, INC.
Entity Type:Organization
Organization Name:JOHNSON NEUROLOGICAL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-889-8877
Mailing Address - Street 1:606 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4336
Mailing Address - Country:US
Mailing Address - Phone:336-889-8877
Mailing Address - Fax:336-889-7832
Practice Address - Street 1:606 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4336
Practice Address - Country:US
Practice Address - Phone:336-889-8877
Practice Address - Fax:336-889-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901790Medicaid
NC0548Medicare PIN
NC2324823Medicare PIN
NC2324823BMedicare PIN
NC2324823AMedicare PIN