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General NPI Number Information
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NPI Number | 1366797367
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Entity Type | Individual
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Provider Name | PETER CHRISTIAN JOHNSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DR.
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City | FT. SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 210-916-7846
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Fax |
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Provider Business Mailing Address
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Address Line | BROOKE ARMY MEDICAL CENTER DEPT. OF ORTHOPAEDICS 3551 ROGER BROOKE DR.
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City | FT. SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 70492
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 70492
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License Number State | GA
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