Individual
MR. PAXTON MCKEOWN JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
833 PRINCETON AVE SW, 200A, BIRMINGHAM, AL 35211
(205) 786-2776
(205) 786-6227
Mailing address
833 PRINCETON AVE SW, 200A, BIRMINGHAM, AL 35211
(205) 786-2776
(205) 786-6227
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-469
AL
363AS0400X
Surgical Physician Assistant
PA9102616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291696700
—
FL
Enumeration date
04/11/2006
Last updated
12/03/2014
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