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NPI Code Detail

MEDICARE: PHILIP NATHANIEL JOHNSON M.D.

MEDICARE: PHILIP NATHANIEL 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
1207V00000XObstetrics & Gynecology PhysicianME66825FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811913866
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP NATHANIEL JOHNSON M.D.
Provider Business Mailing Address
First Line : 2230 SW 19TH AVENUE RD
Second Line :
City : OCALA
State : FL
Zip : 34471-1391
Country : US
Telephone Number : 352-237-4133
Fax Number : 352-237-7728
Provider Business Practice Location Address
First Line : 2701 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6303
Country : US
Telephone Number : 813-738-6690
Fax Number : 813-816-0326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 04/30/2024

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