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NPI Code Detail

MEDICARE: DR. WILLIAM TRASK JOHNSON MD

MEDICARE: DR. WILLIAM TRASK 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
12080P0204XPediatric Emergency Medicine (Pediatrics) Physician77450TN

General Provider Information

NPI Number : 1669162673
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM TRASK JOHNSON MD
Provider Business Mailing Address
First Line : 50 N DUNLAP ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2800
Country : US
Telephone Number : 901-287-5265
Fax Number : 901-287-5062
Provider Business Practice Location Address
First Line : 920 MADISON AVE STE 447
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3438
Country : US
Telephone Number : 901-287-5265
Fax Number : 901-287-5062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2023
Last Update Date : 05/27/2026

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