Individual
JESSE ALEXANDER JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(484) 565-1510
Mailing address
3803 W CHESTER PIKE STE 160, NEWTOWN SQUARE, PA 19073-2336
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD475484
PA
208M00000X
Hospitalist Physician
MD475484
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2019
Last updated
02/18/2025
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