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Individual
DR. JASON DEAN JOHNSON
Active
Individual
DR. JASON DEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P0909
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
036100533
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216741895001
ANTHEM
—
05
—
285993601
—
TX
05
—
285993602
—
TX
05
—
34738800
—
WI
05
—
36100533
—
IL
01
—
P00406743
MEDICARE RR
—
Enumeration date
08/16/2005
Last updated
03/09/2016
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