Healthcare Provider Details

I. General information

NPI: 1063448660
Provider Name (Legal Business Name): WILLIAM M JOHNSON, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 48TH ST SUITE 800
LINCOLN NE
68506-1225
US

IV. Provider business mailing address

1500 S 48TH ST SUITE 800
LINCOLN NE
68506-1225
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8600
  • Fax: 402-483-8689
Mailing address:
  • Phone: 402-483-8600
  • Fax: 402-483-8689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number18678
License Number StateNE

VIII. Authorized Official

Name: DR. WILLIAM M. JOHNSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-483-8600