Individual
MATTHEW S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1026 MAR WALT DR, FORT WALTON BEACH, FL 32547-6645
(850) 863-5294
(850) 864-1648
Mailing address
322 22ND AVE N STE 500, NASHVILLE, TN 37203-1837
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL1607
NV
208600000X
Surgery Physician
Primary
ME137986
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL1607
MEDICAL LICENSE
NV
01
—
ME137986
MEDICAL
FL
Enumeration date
03/16/2007
Last updated
03/03/2026
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