Provider Demographics
NPI:1184615437
Name:JOHNSON, DONALD R II (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:JOHNSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:217 DOZIER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4090
Mailing Address - Country:US
Mailing Address - Phone:843-669-5162
Mailing Address - Fax:843-667-4573
Practice Address - Street 1:1106 CHUCK DAWLEY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4183
Practice Address - Country:US
Practice Address - Phone:843-849-1551
Practice Address - Fax:843-849-6591
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2010-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC12300207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00000850OtherRAILROAD MEDICARE
SC123002Medicaid
SC123002Medicaid
P00000850OtherRAILROAD MEDICARE