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Individual

DR. JOANNA R JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5501 OLD YORK RD, LEVY 2 WEST, PHILADELPHIA, PA 19141-3018
(215) 456-6786
Mailing address
5501 OLD YORK RD, LEVY 2 WEST, PHILADELPHIA, PA 19141-3018
(215) 456-6786

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD017088E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0046132000
KEYSTONE HMO PROVIDER #
PA
01
1031512
KEYSTONE MERCY PROVIDER #
PA
01
1290835006
CIGNA HMO PROVIDER #
PA
01
136289
INDEPENDENCE B/C PROVIDER
PA
01
232295464
CIGNA PPO PROVIDER #
PA
01
856289
AETNA HMO PROVIDER #
PA
Enumeration date
04/13/2006
Last updated
07/16/2010
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