Individual
MR. MATTHEW YOUNG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
831 1ST ST N, ALABASTER, AL 35007-8944
(205) 620-1085
(205) 620-1091
Mailing address
1130 22ND STREET SOUTH SUITE 1000, BIRMINGHAM, AL 35246-8007
(205) 715-5943
(205) 715-5932
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.509
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009942984
—
AL
01
—
51005353
BLUE CROSS
AL
Enumeration date
02/21/2007
Last updated
10/25/2018
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