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General NPI Number Information
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NPI Number | 1073578456
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Entity Type | Individual
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Provider Name | AMY E JOHNSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 2863 HIGHWAY 45 BYP
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City | JACKSON
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State | TN
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Zip | 38305-3618
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Country | US
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Telephone | 731-422-0213
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Fax | 731-660-8369
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | JACKSON
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State | TN
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Zip | 38302-0400
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Country | US
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Telephone | 731-422-0213
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Fax | 731-422-5743
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 49323
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | DR.0049323
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | INPROCESS
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD63332
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License Number State | TN
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