# DR. JOHN EDWARD CHAMPION

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275582439
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | E2505 | TX | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | E2505 | TX | — |
| 208000000X | Pediatrics Physician | E2505 | TX | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | E2505 | TX | — |

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 07/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00TD97 | BCBS ID NUMBER | TX |
| 05 | — | 132990602 | — | TX |
| 01 | — | 132990609 | TEXAS HEALTH STEPS | TX |
| 01 | — | 4019283 | AETNA HMO PROVIDER ID | TX |