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NPI Code Detail

MEDICARE: AMY E JOHNSON M.D.

MEDICARE:   AMY E JOHNSON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician49323CO
2207PP0204XPediatric Emergency Medicine (Emergency Medicine) PhysicianDR.0049323CO
3208000000XPediatrics PhysicianINPROCESSTN
4208000000XPediatrics PhysicianMD63332TN

General Provider Information

NPI Number : 1073578456
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY E JOHNSON M.D.
Provider Business Mailing Address
First Line : PO BOX 400
Second Line :
City : JACKSON
State : TN
Zip : 38302-0400
Country : US
Telephone Number : 731-422-0213
Fax Number : 731-422-5743
Provider Business Practice Location Address
First Line : 2863 HIGHWAY 45 BYP
Second Line :
City : JACKSON
State : TN
Zip : 38305-3618
Country : US
Telephone Number : 731-422-0213
Fax Number : 731-660-8369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 06/21/2021

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Directions to “ AMY E JOHNSON M.D.” Practice Location

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