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NPI Code Detail

MEDICARE: MARC EDWARD JOHNSON M.D.

MEDICARE: MARC EDWARD 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
1207Q00000XFamily Medicine Physician23972MS
2207Q00000XFamily Medicine PhysicianE8843AR
3207QA0505XAdult Medicine PhysicianS-7461TX

General Provider Information

NPI Number : 1730475815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC EDWARD JOHNSON M.D.
Provider Business Mailing Address
First Line : 1350 S MAIN ST STE 1600
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-7663
Country : US
Telephone Number : 601-695-0397
Fax Number :
Provider Business Practice Location Address
First Line : 1350 S MAIN ST STE 1600
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-7663
Country : US
Telephone Number : 817-702-3701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2011
Last Update Date : 05/23/2025

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Directions to “ MARC EDWARD JOHNSON M.D.” Practice Location

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