Individual
IAN GERARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1153 CENTRE ST, JAMAICA PLAIN, MA 02130-3446
(617) 983-7474
Mailing address
1153 CENTRE ST, JAMAICA PLAIN, MA 02130-3446
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
1015490
MA
Other
Enumeration date
04/12/2019
Last updated
07/08/2024
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