Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Glen F Johnson, PA

Individual provider Physician Assistant · NPI 1619971561

Glen F Johnson, PA is a Physician Assistant in Fayetteville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2005.

Licensed in
NC
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

524 Beaumont Rd
Fayetteville, NC 28304-4443
Phone: (800) 476-8646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 00010366 (NC)

Record details

NPI number1619971561
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESFebruary 13, 2008

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