Individual
DR. DEREK K. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(629) 220-0211
(629) 220-0210
Mailing address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(629) 220-0211
(629) 220-0210
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD073165L
PA
208000000X
Pediatrics Physician
Primary
MD40831
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001842036
—
PA
Enumeration date
03/22/2006
Last updated
10/17/2022
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