Individual
STEPHEN MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3473 POPLAR AVE, SUITE 103, MEMPHIS, TN 38111-4654
(901) 320-6915
(901) 320-6920
Mailing address
PO BOX 1000, DEPT 978, MEMPHIS, TN 38148-0001
(901) 320-6915
(901) 320-6920
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54615
TN
208000000X
Pediatrics Physician
54615
TN
Other
Enumeration date
04/01/2011
Last updated
08/08/2016
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