Healthcare Provider Details

I. General information

NPI: 1144237215
Provider Name (Legal Business Name): CARL E JOHNSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HIGH ST
TOPSFIELD MA
01983-1921
US

IV. Provider business mailing address

PO BOX 61
BOXFORD MA
01921-0061
US

V. Phone/Fax

Practice location:
  • Phone: 978-921-1392
  • Fax: 978-887-1971
Mailing address:
  • Phone: 978-857-5722
  • Fax: 978-887-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number46917
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: