Individual
DOUGLAS WILLIAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7015 A C SKINNER PKWY BLDG 100, JACKSONVILLE, FL 32256-6932
(904) 516-3737
(904) 516-3738
Mailing address
PO BOX 19675, JACKSONVILLE, FL 32245-9675
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME43406
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03911
BCBS
FL
01
—
040225
AVMED
FL
05
—
046276400
—
FL
05
—
853120709A
—
GA
01
—
AJ038S
MEDICARE PTAN
FL
01
—
P00191285
MEDICARE RAILROAD
FL
Enumeration date
04/26/2006
Last updated
03/17/2018
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