# JOHNSON MEDICAL SPECIALISTS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720214034
- **Authorized official:** CHARLES BIZILJ MD (PRESIDENT)
- **Authorized official phone:** (860) 684-8125

## Contact information

- **Practice address:** 201 CHESTNUT HILL RD, ATTN: LORI LADUE, STAFFORD SPRINGS, CT 06076-4005
- **Practice address phone:** (860) 684-8415
- **Mailing address:** 201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
- **Mailing address phone:** (860) 684-8415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | CT | Yes |

## Other

- **Enumeration date:** 06/02/2009
- **Last updated:** 12/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | D100000258 | MEDICARE PTAN | CT |