Provider Demographics
NPI:1467745513
Name:JOHNSTON, TAMMY JERNIGAN (MD)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JERNIGAN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHARLESTON RDG
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-4549
Mailing Address - Country:US
Mailing Address - Phone:828-788-2436
Mailing Address - Fax:
Practice Address - Street 1:45 PLATEAU ST
Practice Address - Street 2:ST #250
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-4200
Practice Address - Country:US
Practice Address - Phone:828-488-4205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33541207Q00000X
NC2014-01306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine