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Individual

DR. MARIO JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1417 MONROE AVE, MEMPHIS, TN 38104-3634
(901) 272-7200
(901) 272-0821
Mailing address
3121 STEEPLEGATE DR, GERMANTOWN, TN 38138-7745

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
114648
TN
367500000X
Certified Registered Nurse Anesthetist
209016529
IL
367500000X
Certified Registered Nurse Anesthetist
26516
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11043007
FL

Other

Enumeration date
08/15/2017
Last updated
11/18/2025
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