MEDICARE: DR. JOSEPH A. JOHNSON M.D.

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	208600000X	Surgery Physician	180345	NY
2	174400000X	Specialist

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	:	1508860248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH A. JOHNSON M.D.

Provider Business Mailing Address
First Line	:	1000 SOUTH AVE
Second Line	:	# 95
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2733
Country	:	US
Telephone Number	:	585-341-8485
Fax Number	:	585-341-8326

Provider Business Practice Location Address
First Line	:	1000 SOUTH AVE
Second Line	:	# 95
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2733
Country	:	US
Telephone Number	:	585-341-8485
Fax Number	:	585-341-8326

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/05/2023

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