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General NPI Number Information
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NPI Number | 1295753762
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Entity Type | Individual
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Provider Name | JAMES W JOHNSON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 5180 PARK AVE SUITE 250
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City | MEMPHIS
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State | TN
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Zip | 38119
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Country | US
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Telephone | 901-753-3766
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Fax | 901-759-1184
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Provider Business Mailing Address
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Address Line | PO BOX 772193
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City | MEMPHIS
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State | TN
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Zip | 38177
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Country | US
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Telephone | 901-761-9901
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Fax | 901-761-9675
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD0000011485
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 17134
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD0000011485
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17134
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License Number State | MS
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