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NPI Code Detail

MEDICARE: ALAN GERALD JOHNSON M.D.

MEDICARE: ALAN GERALD 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
1207P00000XEmergency Medicine PhysicianMD463371PA

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 : 1881077667
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN GERALD JOHNSON M.D.
Provider Business Mailing Address
First Line : PO BOX 8209
Second Line :
City : VIENNA
State : VA
Zip : 22183-2058
Country : US
Telephone Number : 251-901-3011
Fax Number : 251-901-3011
Provider Business Practice Location Address
First Line : 850 CONCOURSE PKWY S STE 200
Second Line :
City : MAITLAND
State : FL
Zip : 32751-6145
Country : US
Telephone Number : 855-479-4217
Fax Number : 888-557-9724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 04/07/2026

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