Individual
JOHNNY WASHINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1010
(904) 244-3457
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 383-1010
(904) 244-3457
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME133343
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
64298
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003150119A
—
GA
05
—
003150119B
—
GA
05
—
003150119C
—
GA
05
—
003150119D
—
GA
05
—
003150119E
—
GA
05
—
003150119F
—
GA
05
—
003150119G
—
GA
05
—
003150119H
—
GA
05
—
003150119I
—
GA
05
—
003150119J
—
GA
05
—
003150119K
—
GA
05
—
003150119L
—
GA
01
—
02427208
AMERIGROUP
GA
01
—
0532272
CIGNA
GA
01
—
1023416
WELLCARE
—
01
—
202I208229
MEDICARE
GA
Enumeration date
10/07/2008
Last updated
07/21/2022
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