MEDICARE: DR. JOHNNIE WAYNE STRICKLAND JR. M.D.

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	16079	AL

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	051026728	OTHER	AL	BCBS OF ALABAMA

General Provider Information

NPI Number	:	1538152483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNNIE WAYNE STRICKLAND JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 680519
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36068-0519
Country	:	US
Telephone Number	:	334-361-8555
Fax Number	:	866-923-0406

Provider Business Practice Location Address
First Line	:	270 INTERSTATE COMMERCIAL PARK LOOP
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-7361
Country	:	US
Telephone Number	:	334-361-8225
Fax Number	:	334-361-0377

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	08/11/2014

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