Organization
EAST COAST PODIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD C JOHNSON JR. DPM (DPM / OWNER)
(386) 672-6424
Entity
Organization
Contact information
Practice address
233 OSCEOLA AVE, ORMOND BEACH, FL 32176-6638
(386) 672-6424
(386) 672-5251
Mailing address
233 OSCEOLA AVE, ORMOND BEACH, FL 32176-6638
(386) 672-6424
(386) 672-5251
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K0055
MEDICARE GROUP NUMBER
—
Enumeration date
10/15/2007
Last updated
07/09/2010
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