Individual
DR. JASON MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2433
(203) 688-9258
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2433
(203) 688-9258
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
75670
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347050201
—
TX
01
—
347050203
CSHCN MEDICAID TPI
TX
Enumeration date
04/11/2007
Last updated
01/22/2024
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