MEDICARE: ROBERT MILTON JOHNSON DO

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	5101007831	MI

General Provider Information

NPI Number	:	1902892177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MILTON JOHNSON DO

Provider Business Mailing Address
First Line	:	5788 ECKHERT RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3900
Country	:	US
Telephone Number	:	210-699-2240
Fax Number	:

Provider Business Practice Location Address
First Line	:	5788 ECKHERT RD
Second Line	:	FRANK M. TEJEDA VA OUTPATIENT CLINIC
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3900
Country	:	US
Telephone Number	:	210-699-2240
Fax Number	:

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	11/28/2007

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