MEDICARE: DR. BRANDON SCOTT JOHNSON 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	207RH0003X	Hematology & Oncology Physician	ME93061	FL
2	207RH0003X	Hematology & Oncology Physician	23481	AL

General Provider Information

NPI Number	:	1730162595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON SCOTT JOHNSON M.D.

Provider Business Mailing Address
First Line	:	2000 PEPPERELL PKWY
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-5452
Country	:	US
Telephone Number	:	334-528-4411
Fax Number	:	334-528-4414

Provider Business Practice Location Address
First Line	:	2000 PEPPERELL PKWY
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-5452
Country	:	US
Telephone Number	:	334-528-4411
Fax Number	:	334-528-4414

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	07/10/2008

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