MEDICARE: MR. ROBERT M JOHNSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD0000004294	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003801143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT M JOHNSON MD

Provider Business Mailing Address
First Line	:	2410 PATTERSON ST
Second Line	:	SUITE 106
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1551
Country	:	US
Telephone Number	:	615-340-4611
Fax Number	:	615-340-4658

Provider Business Practice Location Address
First Line	:	2410 PATTERSON ST
Second Line	:	SUITE 106
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1551
Country	:	US
Telephone Number	:	615-340-4611
Fax Number	:	615-340-4658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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