Individual
MRS. MEGAN D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1497 W ELK AVE, SUITE 21, ELIZABETHTON, TN 37643-2895
(423) 542-7420
(423) 542-7425
Mailing address
1497 W ELK AVE, SUITE 21, ELIZABETHTON, TN 37643-2895
(423) 542-7420
(423) 542-7425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457644254
—
VA
01
—
6023539
BLUECARE
TN
05
—
Q008037
—
TN
Enumeration date
05/26/2011
Last updated
02/10/2017
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