Individual
DR. CHARLES E JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
BRYCE HOSPITAL, 200 UNIVERSITY BLVD, TUSCALOOSA, AL 35401-1205
(205) 759-0799
(205) 759-0845
Mailing address
200 UNIVERSITY BLVD, TUSCALOOSA, AL 35401-1205
(205) 759-0799
(205) 759-0845
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3516
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009947605
—
AL
01
—
51000265
BCBS
AL
Enumeration date
08/21/2006
Last updated
05/09/2008
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