Individual
DR. JEFFERY LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
603 7TH ST SO, #500, ST PETERSBURG, FL 33701-4734
(727) 822-0442
(727) 821-0416
Mailing address
603 7TH ST SO, #500, ST PETERSBURG, FL 33701-4734
(727) 822-0442
(727) 821-0416
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D59146
MD
208600000X
Surgery Physician
Primary
ME71729
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404698600
—
MD
Enumeration date
07/06/2006
Last updated
01/12/2010
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