Healthcare Provider Details

I. General information

NPI: 1811060825
Provider Name (Legal Business Name): RONALD JOSEPH JOHNSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 N KEY AVE
LAMPASAS TX
76550-1106
US

IV. Provider business mailing address

2604 N BEAL ST
BELTON TX
76513-1638
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-3682
  • Fax:
Mailing address:
  • Phone: 254-217-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH6862
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: