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Individual

BRIAN D JOHNSON

Active
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Individual

BRIAN D JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

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
Update your record

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