Individual
MR. MICHAEL FREDERICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1802 N JACKSON ST, TULLAHOMA, TN 37388-8218
(931) 455-4529
(931) 455-4633
Mailing address
1802 NORTH JACKSON STREET, SUITE 8, TULLAHOMA, TN 37388
(931) 455-4520
(931) 455-4633
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1564
TN
Other
Enumeration date
07/23/2008
Last updated
08/08/2011
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