MEDICARE: DR. DANNA ELIZABETH JOHNSON MD

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	207ZC0500X	Cytopathology Physician	0101041790	VA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0101041790	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	220024925	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28794	OTHER		OPTIMAHEALTH

General Provider Information

NPI Number	:	1316948052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANNA ELIZABETH JOHNSON MD

Provider Business Mailing Address
First Line	:	5301 VIRGINIA WAY STE 300
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7542
Country	:	US
Telephone Number	:	615-221-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MEDICAL PARK BLVD
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9274
Country	:	US
Telephone Number	:	615-221-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	06/12/2019

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