MEDICARE: FAMILY MEDICINE OF SARDIS PC

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
1	207Q00000X	Family Medicine Physician	DO779	AL

General Provider Information

NPI Number	:	1245398304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICINE OF SARDIS PC

Provider Business Mailing Address
First Line	:	PO BOX 1049
Second Line	:
City	:	BOAZ
State	:	AL
Zip	:	35957-2201
Country	:	US
Telephone Number	:	256-593-9999
Fax Number	:	256-593-9141

Provider Business Practice Location Address
First Line	:	1180 SARDIS DR
Second Line	:
City	:	SARDIS CITY
State	:	AL
Zip	:	35956-2139
Country	:	US
Telephone Number	:	256-593-9999
Fax Number	:	256-593-9141

Authorized Official
Title or Position	:	PRESIDENT, OWNER
Name	:	DR. EVAN MICHAEL JOHNSON
Credential	:	D.O.
Telephone Number	:	256-593-9999

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/11/2007

Similar Medicare Providers

1659399772 — DR. EVAN MICHAEL JOHNSON D.O.
Practice Location Address:

1180 SARDIS DR
SARDIS CITY, AL
35956-2139

Practice Phone: 256-593-9999
Practice Fax: 256-593-9141

1265662183 — MRS. KATHY LEIGH VAUGHN CRNP
Practice Location Address:

1180 SARDIS DR
BOAZ, AL
35956-2139

Practice Phone: 256-593-9999
Practice Fax: 256-593-9141

1770040941 — COURTNEY CHLOE WRIGHT
Practice Location Address:

1180 SARDIS DR
BOAZ, AL
35956-2139

Practice Phone: 256-593-9999
Practice Fax: 256-593-9141

1063434561 — CHERIE L KEAHEY CRNP
Practice Location Address:

1989 SARDIS DR
SARDIS CITY, AL
35956-2344

Practice Phone: 256-492-0131
Practice Fax:

1912055104 — CROSSVILLE CHIROPRACTIC HEALTH CENTER
Practice Location Address:

12815 US HIGHWAY 431
SARDIS CITY, AL
35956-2046

Practice Phone: 256-593-3551
Practice Fax: 256-593-4603

1720131386 — DR. TAURET P. BURKE D.C.
Practice Location Address:

12815 US HIGHWAY 431
SARDIS CITY, AL
35956-2046

Practice Phone: 256-593-3551
Practice Fax: 256-593-4603

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