Individual
BRIAN D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 E THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 602-8400
(423) 602-8401
Mailing address
PO BOX 2930, INDIANAPOLIS, IN 46206-2930
(844) 468-9496
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
040424
GA
207L00000X
Anesthesiology Physician
35.053100
OH
207L00000X
Anesthesiology Physician
Primary
MD20995
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000509319B
—
GA
05
—
009902270
—
AL
01
—
050057059
MEDICARE RAILROAD
TN
05
—
3057836
—
TN
01
—
3067783
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
05
—
89067CN
—
NC
01
—
N383405
WELLCARE (GA MEDICAID)
GA
Enumeration date
08/18/2006
Last updated
11/10/2016
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