Individual
JAMIE L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 W LAKE PROFESSIONAL PARK STE 3, GENEVA, AL 36340-1200
(334) 684-8905
(334) 684-8908
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1-118761
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280895
—
AL
Enumeration date
07/06/2018
Last updated
06/14/2022
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