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General NPI Number Information
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NPI Number | 1154684470
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Entity Type | Individual
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Provider Name | DAVID ANDREW JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 27961 US HIGHWAY 98 SUITE 14
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City | DAPHNE
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State | AL
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Zip | 36526-4702
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Country | US
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Telephone | 251-626-1175
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Fax | 251-591-4145
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Provider Business Mailing Address
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Address Line | 27961 US HIGHWAY 98 SUITE 14
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City | DAPHNE
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State | AL
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Zip | 36526-4702
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Country | US
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Telephone | 251-626-1175
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Fax | 251-591-4145
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10044614
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License Number State | TX
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