Individual
HAROLD TIMOTHY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1005 MAR WALT DR, FAMILY MEDICINE DEPARTMENT, FORT WALTON BEACH, FL 32547-6707
(850) 863-6600
(850) 862-0977
Mailing address
1005 MAR WALT DR, FAMILY MEDICINE DEPARTMENT, FORT WALTON BEACH, FL 32547-6707
(850) 863-6600
(850) 862-0977
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101157
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290698800
—
FL
01
—
Y0CH5
BCBSFL
FL
Enumeration date
12/14/2005
Last updated
01/17/2017
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