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NPI Code Detail

MEDICARE: LINDA LOU JOHNSON MD

MEDICARE: LINDA LOU 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
1207R00000XInternal Medicine Physician11169NV

General Provider Information

NPI Number : 1033182522
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA LOU JOHNSON MD
Provider Business Mailing Address
First Line : 102 WOODMONT BLVD STE 600
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-5250
Country : US
Telephone Number : 615-314-5257
Fax Number : 615-692-0547
Provider Business Practice Location Address
First Line : 1501 W SUNSET RD
Second Line :
City : HENDERSON
State : NV
Zip : 89014-6636
Country : US
Telephone Number : 725-269-7001
Fax Number : 725-269-7003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 07/20/2022

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