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1376548222

NPI Code Detail

MEDICARE: DR. JAMES CLIFTON JOHNSON MD

MEDICARE: DR. JAMES CLIFTON 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	207U00000X	Nuclear Medicine Physician	33848	NC
2	2085N0700X	Neuroradiology Physician	33848	NC
3	2085R0202X	Diagnostic Radiology Physician	33848	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376548222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CLIFTON JOHNSON MD

Provider Business Mailing Address
First Line	:	PO BOX 221249
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28222-1249
Country	:	US
Telephone Number	:	704-332-1291
Fax Number	:	704-332-5206

Provider Business Practice Location Address
First Line	:	3623 LATROBE DR STE 216
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2117
Country	:	US
Telephone Number	:	704-332-1291
Fax Number	:	704-926-1832

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/01/2020

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Directions to “ DR. JAMES CLIFTON JOHNSON MD” Practice Location

Language	Start Address	Practice Location

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