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NPI Code Detail

MEDICARE: JENNIFER ARTEMIS JOHNSON PA

MEDICARE:   JENNIFER ARTEMIS JOHNSON  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
1363AM0700XMedical Physician AssistantPA03207TX
2363A00000XPhysician AssistantPA03207TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1741622343OTHERTXTAX ID#

General Provider Information

NPI Number : 1770505943
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ARTEMIS JOHNSON PA
Provider Business Mailing Address
First Line : 2101 MAIN ST
Second Line :
City : JUNCTION
State : TX
Zip : 76849-3024
Country : US
Telephone Number : 325-446-3305
Fax Number :
Provider Business Practice Location Address
First Line : 109 REID RD
Second Line :
City : JUNCTION
State : TX
Zip : 76849-3008
Country : US
Telephone Number : 325-446-3305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 02/22/2010

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Directions to “ JENNIFER ARTEMIS JOHNSON PA” Practice Location

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