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General NPI Number Information
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NPI Number | 1417449885
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Entity Type | Individual
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Provider Name | LORA JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 758 HIGHWAY 46 S
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City | DICKSON
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State | TN
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Zip | 37055-2502
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Country | US
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Telephone | 615-446-2708
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Fax | 615-441-5121
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Provider Business Mailing Address
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Address Line | 127 CRESTVIEW PARK DR STE 209
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City | DICKSON
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State | TN
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Zip | 37055-2856
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Country | US
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Telephone | 615-446-5121
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Fax | 615-446-1359
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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 | 64059
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License Number State | TN
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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 | BP10062854
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License Number State | TX
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