MEDICARE: DR. SONYA LASHAWN 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	207Q00000X	Family Medicine Physician	31316	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

General Provider Information

NPI Number	:	1225019086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONYA LASHAWN JOHNSON MD

Provider Business Mailing Address
First Line	:	9448 DAYTON PIKE
Second Line	:
City	:	SODDY DAISY
State	:	TN
Zip	:	37379-4750
Country	:	US
Telephone Number	:	423-778-8500
Fax Number	:	423-778-8501

Provider Business Practice Location Address
First Line	:	9448 DAYTON PIKE
Second Line	:
City	:	SODDY DAISY
State	:	TN
Zip	:	37379-4750
Country	:	US
Telephone Number	:	423-778-8500
Fax Number	:	423-778-8501

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	11/06/2024

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