OrganizationAllyn C Johnson Jr MdpcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address675 White Sulphur Rd, Suite #280, Gainesville, GA 30501-8921(770) 532-9973PECOS EnrollmentBased on the most recent information from CMS, provider Allyn C Johnson Jr Mdpc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1700040060Provider TypeOrganizationFull NameAllyn C Johnson Jr MdpcSubpartNoEnumeration Date7/16/2008Last Updated7/16/2008Contact InformationPractice LocationPractice Address675 White Sulphur Rd, Suite #280, Gainesville, GA 30501-8921Phone(770) 532-9973Fax(770) 503-0775Mailing LocationMailing Address675 White Sulphur Rd, Suite #280, Gainesville, GA 30501-8921Phone(770) 532-9973Fax(770) 503-0775Authorized OfficialNameBellotte, Kathy A (Office Manager)Phone(770) 532-9973Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense06661GeorgiaProvider IdentifiersIDDescriptionIssuerID00269992BDescriptionMedicaidIssuerUnlistedGeorgia