Healthcare Provider Details

I. General information

NPI: 1447461009
Provider Name (Legal Business Name): ERIK ROBERT JOHNSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

TRIPLER ARMY MEDICAL CENTER 1 JARRETT WHITE RD
HONOLULU HI
96859
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6338
  • Fax:
Mailing address:
  • Phone: 808-633-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number7680399-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: