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General NPI Number Information
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NPI Number | 1891054110
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Entity Type | Organization
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Legal Business Name | DR. WARREN H. JOHNSON, PODIATRIST, PC
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 6305 ELYSIAN FIELDS AVE SUITE 204
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City | NEW ORLEANS
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State | LA
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Zip | 70122-4245
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Country | US
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Telephone | 504-286-0202
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Fax | 504-286-0702
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Provider Business Mailing Address
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Address Line | 6305 ELYSIAN FIELDS AVE SUITE 204
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City | NEW ORLEANS
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State | LA
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Zip | 70122-4245
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Country | US
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Telephone | 504-286-0202
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Fax | 504-286-0702
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Authorized Official
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Title or Position | VP/ADMINISTRATOR
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Name | DR. CAROLYN J. JOHNSON
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Credential | PH.D.
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Telephone | 504-286-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 207800
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License Number State | LA
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