Individual
IAN JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1907 HIGHWAY 44 W, INVERNESS, FL 34453-3801
(352) 344-2273
(352) 344-2204
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110730
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1132854
PROFESSIONAL LICENSE
FL
Enumeration date
10/16/2017
Last updated
04/09/2021
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