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General NPI Number Information
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NPI Number | 1801114293
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Entity Type | Organization
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Legal Business Name | J W JOHNSON DO PA
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 901 W HAMILTON ST
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City | OLNEY
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State | TX
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Zip | 76374-1725
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Country | US
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Telephone | 940-564-3546
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 277
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City | OLNEY
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State | TX
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Zip | 76374-0277
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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 | DO PA
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Name | JEREMY JOHNSON
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Credential |
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Telephone | 940-564-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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