Provider Demographics
NPI:1669422010
Name:JOHNSON, WILLIAM HOLLAND JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOLLAND
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9710 ALMAVIVA DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4989
Mailing Address - Country:US
Mailing Address - Phone:404-983-6759
Mailing Address - Fax:
Practice Address - Street 1:6920 MCGINNIS FERRY RD STE 340
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6675
Practice Address - Country:US
Practice Address - Phone:770-232-2911
Practice Address - Fax:770-232-2996
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057867208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901911Medicaid
NCOTH000Medicare UPIN
NC5901911Medicaid