Individual
RONNY CARL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
0008023
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004070317
AETNA
—
05
—
051514734
—
AL
05
—
126131
—
AL
01
—
511-11829
BCBS-AL
AL
01
—
51514734JOH
BLUE CROSS BLUE SHIELD
AL
01
—
P00000018
MEDICARE RAILROAD
AL
Enumeration date
06/05/2006
Last updated
08/10/2015
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