MEDICARE: BENJAMIN W JOHNSON JR. 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	207L00000X	Anesthesiology Physician	21653	TN
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	21653	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1982674164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN W JOHNSON JR. M.D.

Provider Business Mailing Address
First Line	:	1326 PAPERMILL POINTE WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-1903
Country	:	US
Telephone Number	:	865-673-5000
Fax Number	:	865-888-9486

Provider Business Practice Location Address
First Line	:	1342 PAPERMILL POINTE WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-1903
Country	:	US
Telephone Number	:	865-673-5000
Fax Number	:	865-588-5711

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	04/02/2020

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