Individual
CHARLES FELZEN JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-4554
(614) 722-4565
Mailing address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-4554
(614) 722-4565
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
35046983
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105315000
MEDICAID
WV
05
—
0476560
—
OH
01
—
64789324
MEDICAID
KY
Enumeration date
08/22/2005
Last updated
07/08/2007
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