Individual
L DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Mailing address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
17211
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3025550
—
TN
Enumeration date
09/21/2006
Last updated
02/29/2012
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