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NPI Code Detail

MEDICARE: JAMES H JOHNSON MD PA

MEDICARE: JAMES H JOHNSON MD PA
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
1174400000XSpecialistME0008984FL

Other Identifiers

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

General Provider Information

NPI Number : 1144399676
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES H JOHNSON MD PA
Provider Business Mailing Address
First Line : 1010 LAKESHORE DR
Second Line :
City : AUBURNDALE
State : FL
Zip : 33823-9738
Country : US
Telephone Number : 863-965-1746
Fax Number : 863-683-9805
Provider Business Practice Location Address
First Line : 2112 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2906
Country : US
Telephone Number : 863-688-0540
Fax Number : 863-683-9805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 08/25/2010

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