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1598009938 NPI number — MARK R JOHNSON

NPI Number: 1598009938
Health Care Provider/Practitioner: MARK R JOHNSON

Information about “1598009938” NPI (MARK R JOHNSON) exists in 1598009938 in HTML format HTML  |  1598009938 in plain Text format TXT  |  1598009938 in PDF (Portable Document Format) PDF  |  1598009938 in an XML format XML  formats.

NPI Number : 1598009938 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598009938",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "MARK",
    "MiddleName": "R",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "273 12TH ST NE",
    "SecondLineMailingAddress": "UNIT 313",
    "MailingAddressCityName": "ATLANTA",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30309-3853",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "985-788-4598",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "273 12TH ST NE",
    "SecondLinePracticeLocationAddress": "UNIT 313",
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30309-3853",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "985-788-4598",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/26/2012",
    "LastUpdateDate": "11/26/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "13210",
          "LicenseNumberStateCode": "LA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "14338",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "010668",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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