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General NPI Number Information
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NPI Number | 1235131848
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Entity Type | Individual
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Provider Name | DAVID GRANT JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 2131 E STATE ST
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City | ATHENS
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State | OH
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Zip | 45701-2138
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Country | US
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Telephone | 740-589-3100
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Fax | 740-589-3123
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Provider Business Mailing Address
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Address Line | 90 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1560
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Country | US
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Telephone | 740-589-3100
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Fax | 740-589-3123
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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 | 35.057127
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12479
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35.057127
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License Number State | OH
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