Individual
DR. RICHARD W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
200 SOUTHPARK BLVD, STE 208, ST AUGUSTINE, FL 32086-3129
(904) 826-1900
(904) 826-1920
Mailing address
200 SOUTHPARK BLVD, STE 208, ST AUGUSTINE, FL 32086-3129
(904) 826-1900
(904) 826-1920
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340246100
—
FL
01
—
6326530001
MEDICARE - DME
FL
Enumeration date
06/01/2006
Last updated
04/06/2010
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