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General NPI Number Information
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NPI Number | 1346336237
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Entity Type | Individual
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Provider Name | FIELDING JOHNSON III M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 893 MAIN ST STE 202
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City | EAST HARTFORD
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State | CT
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Zip | 06108-2293
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Country | US
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Telephone | 860-528-4124
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Fax | 860-282-1213
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Provider Business Mailing Address
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Address Line | 7 FALCON LN
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City | GLASTONBURY
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State | CT
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Zip | 06033-2731
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Country | US
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Telephone | 860-633-6706
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Fax |
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 038695
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 038695
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License Number State | CT
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