Individual
DR. EVAN MICHAEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1180 SARDIS DR, SARDIS CITY, AL 35956-2139
(256) 593-9999
(256) 593-9141
Mailing address
PO BOX 1049, BOAZ, AL 35957-2201
(256) 593-9999
(256) 593-9141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO779
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521836
BC/BS PROV. NUMBER
AL
Enumeration date
07/17/2006
Last updated
12/12/2007
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