Healthcare Provider Details

I. General information

NPI: 1568563328
Provider Name (Legal Business Name): MICHAEL JOHNSON PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPT OF VETERANS AFFAIRS MEDICAL CENTER 700 SOUTH 19TH STREET
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

4131 EAGLE CREST DRIVE
BIRMINGHAM AL
35242-4923
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-8101
  • Fax:
Mailing address:
  • Phone: 205-408-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10927
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: