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NPI Code Detail

MEDICARE: DR. DEONNA D JOHNSON M.D.

MEDICARE: DR. DEONNA D 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 Physician54248TN

General Provider Information

NPI Number : 1164865630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEONNA D JOHNSON M.D.
Provider Business Mailing Address
First Line : 3841 GREEN HILLS VILLAGE DR STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-2691
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3601 THE VANDERBILT CLINIC
Second Line :
City : NASHVILLE
State : TN
Zip : 37232-5100
Country : US
Telephone Number : 615-322-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2013
Last Update Date : 06/25/2026

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