Individual
DR. TEDDY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
680 W MONROE ST, WYTHEVILLE, VA 24382-2240
(276) 228-2212
(276) 228-7835
Mailing address
680 W MONROE ST, WYTHEVILLE, VA 24382-2240
(276) 228-2212
(276) 228-7835
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000769
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101908
ANTHEM
VA
01
—
101911
ANTHEM
VA
01
—
324208
ANTHEM
VA
01
—
324212
ANTHEM
VA
01
—
5442037
AETNA
VA
01
—
9020630
CIGNA
VA
Enumeration date
04/10/2006
Last updated
10/25/2007
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