Individual
MRS. MARY HEATHER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3103 BUSINESS PARK CIR STE 100, GOODLETTSVILLE, TN 37072-3676
(615) 851-7865
(615) 851-7853
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 381-1509
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD29117
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1240316
UNITED HEALTHCARE HMO
—
01
—
3146836
BLUE CROSS
TN
05
—
3898510
—
TN
01
—
8806699002
CIGNA COMM
—
01
—
8806699003
CIGNA HMO
—
01
—
949814
AETNA
—
Enumeration date
09/30/2005
Last updated
12/01/2025
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