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Organization
JOHNSON PROFESSIONAL ASSOCIATES, PC
Active
Organization
JOHNSON PROFESSIONAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN S. TUCKER MD (PRESIDENT)
(860) 684-8478
Entity
Organization
Contact information
Practice address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 272-2916
(860) 272-2993
Mailing address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 684-8478
(860) 684-8123
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004196459
—
CT
05
—
004226735
—
CT
05
—
004262143
—
CT
05
—
004396489
—
CT
Enumeration date
11/10/2005
Last updated
07/17/2015
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