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NPI Code Detail

MEDICARE: JULIAN B JOHNSON II

MEDICARE: JULIAN B JOHNSON II
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
1372600000XAdult Companion

General Provider Information

NPI Number : 1497883342
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIAN B JOHNSON II
Provider Business Mailing Address
First Line : 2421 MADISON ST APT 15
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-5462
Country : US
Telephone Number : 931-220-6850
Fax Number :
Provider Business Practice Location Address
First Line : 118 UNION ST
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5115
Country : US
Telephone Number : 931-647-8257
Fax Number : 931-647-2978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/08/2007

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Directions to “ JULIAN B JOHNSON II ” Practice Location

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