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General NPI Number Information
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NPI Number | 1558337022
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Entity Type | Individual
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Provider Name | JAMES LEWIS JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 44 MCCOY AVE HEART CARE ASSOCIATES, PSC
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City | MADISONVILLE
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State | KY
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Zip | 42431-2867
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Country | US
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Telephone | 270-821-0677
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Fax | 270-821-2539
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Provider Business Mailing Address
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Address Line | 44 MCCOY AVE, BOX 9 HEART CARE ASSOCIATES, PSC
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City | MADISONVILLE
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State | KY
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Zip | 42431-2867
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Country | US
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Telephone | 270-821-0677
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Fax | 270-821-2539
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 20960
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD0000036916
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License Number State | TN
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