Healthcare Provider Details

I. General information

NPI: 1720696552
Provider Name (Legal Business Name): JOEL SCOTT JOHNSON II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR MASTIN 212
MOBILE AL
36617
US

IV. Provider business mailing address

2451 UNIVERSITY HOSPITAL DRIVE MASTIN 212
MOBILE AL
36617
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3378
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3378
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: