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General NPI Number Information
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NPI Number | 1316459829
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Entity Type | Organization
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Legal Business Name | GERALD E JOHNSON MD PLLC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 6142 SHALLOWFORD RD STE 103
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7216
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Country | US
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Telephone | 423-498-3300
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Fax | 423-498-3301
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Provider Business Mailing Address
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Address Line | 6142 SHALLOWFORD RD STE 103
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7216
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Country | US
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Telephone | 423-498-3300
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Fax | 423-498-3301
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Authorized Official
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Title or Position | RN/OFFICE MANAGER
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Name | MRS. CATHARINE JOHNSON
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Credential | RN
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Telephone | 423-498-3870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 32248
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License Number State | TN
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