Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DN013316 | GA |
N | 1223G0001X | General Practice | DN013316 | GA |
N | 213EG0000X | General Practice | DN013316 | GA |
NPI | 1326267261 |
---|---|
Provider Name | Dr. Toby Johnson Clarkson |
First Address | Blairsville, GA 30512-3937 |
Second Address | Dalton, GA 30720-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |