Individual
JEFFREY DAVID JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-1521
(352) 273-5199
Mailing address
PO BOX 100264, GAINESVILLE, FL 32610-0264
(352) 273-5199
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME150300
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110611200
—
FL
Enumeration date
04/01/2015
Last updated
01/03/2023
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