Individual
DERRICK E. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7277 SMITHS MILL RD, #250, NEW ALBANY, OH 43054-8195
(614) 464-0162
(614) 464-0157
Mailing address
6480 HARRISON AVE STE 201, CINCINNATI, OH 45247-7961
(614) 224-7697
(614) 221-5613
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-089645
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891983623
NPI
—
05
—
2855661
—
OH
01
—
JO7378991
MEDICARE
OH
Enumeration date
10/05/2007
Last updated
07/21/2023
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