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Individual

PHILIP NATHANIEL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2701 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6303
(813) 738-6690
(813) 816-0326
Mailing address
2230 SW 19TH AVENUE RD, OCALA, FL 34471-1391
(352) 237-4133
(352) 237-7728

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME66825
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
379110600
FL
Enumeration date
07/14/2006
Last updated
04/30/2024
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