Healthcare Provider Details

I. General information

NPI: 1073668604
Provider Name (Legal Business Name): WILLIAM L. JOHNSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 LAUREL AVE SUITE 402 NEWLAND PROFESSIONAL BLDG.
KNOXVILLE TN
37916-1810
US

IV. Provider business mailing address

2001 LAUREL AVE SUITE 402 NEWLAND PROFESSIONAL BLDG.
KNOXVILLE TN
37916-1810
US

V. Phone/Fax

Practice location:
  • Phone: 865-632-5577
  • Fax: 865-632-5584
Mailing address:
  • Phone: 865-632-5577
  • Fax: 865-632-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number24287
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: