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General NPI Number Information
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NPI Number | 1033192034
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Entity Type | Individual
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Provider Name | ALEX WILLIAM JOHNSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 2006 FRANKLIN ST SE SUITE 200
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4551
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Country | US
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Telephone | 256-539-0457
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Fax | 256-539-5827
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Provider Business Mailing Address
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Address Line | 2006 FRANKLIN ST SE STE 200
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4537
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Country | US
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Telephone | 256-539-0457
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Fax | 256-539-5827
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 55173
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 19651
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License Number State | AL
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