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NPI Code Detail

MEDICARE: J W JOHNSON DO PA

MEDICARE: J W JOHNSON DO 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
1207P00000XEmergency Medicine Physician
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1801114293
Entity Type Code : Organization
Provider Name (Legal Business Name) : J W JOHNSON DO PA
Provider Business Mailing Address
First Line : PO BOX 277
Second Line :
City : OLNEY
State : TX
Zip : 76374-0277
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 W HAMILTON ST
Second Line :
City : OLNEY
State : TX
Zip : 76374-1725
Country : US
Telephone Number : 940-564-3546
Fax Number :
Authorized Official
Title or Position : DO PA
Name : JEREMY JOHNSON
Credential :
Telephone Number : 940-564-3546
Provider Enumeration Date : 05/10/2010
Last Update Date : 05/10/2010

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Directions to “J W JOHNSON DO PA ” Practice Location

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