Individual
MR. EDWARD ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1099 A1A BEACH BLVD, ST AUGUSTINE, FL 32080
(904) 471-9104
(904) 461-3386
Mailing address
10 13TH STREET, ST AUGUSTINE, FL 32080
(904) 540-7740
(904) 461-3386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA3355
FL
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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