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NPI Code Detail

MEDICARE: DR. DONALD CHARLES JOHNSON JR. DPM

MEDICARE:  DR. DONALD CHARLES JOHNSON JR. DPM
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
1213EP1101XPrimary Podiatric Medicine PodiatristPO-2558FL
2213ES0103XFoot & Ankle Surgery PodiatristPO-2558FL

Other Identifiers

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

General Provider Information

NPI Number : 1386637700
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD CHARLES JOHNSON JR. DPM
Provider Business Mailing Address
First Line : 233 OSCEOLA AVE
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32176-6638
Country : US
Telephone Number : 386-672-6424
Fax Number : 386-672-5251
Provider Business Practice Location Address
First Line : 233 OSCEOLA AVE
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32176-6638
Country : US
Telephone Number : 386-672-6424
Fax Number : 386-672-5251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 08/23/2013

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Directions to “ DR. DONALD CHARLES JOHNSON JR. DPM” Practice Location

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