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Individual
DR. JEFFERY ALAN JOHNSON
Active
Individual
DR. JEFFERY ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A81750
CA
2080P0210X
Pediatric Nephrology Physician
Primary
ME119884
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A81750
BLUE SHIELD
—
05
—
011160500
—
FL
01
—
ME119884
MEDICAL LICENSE
FL
Enumeration date
04/03/2006
Last updated
11/15/2016
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