Individual
DENVER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1060 PEERLESS XING NW STE 200, CLEVELAND, TN 37312-3785
(423) 479-4165
Mailing address
5354 SATELITE CT, OOLTEWAH, TN 37363-4822
(423) 827-7581
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4383
TN
Other
Enumeration date
12/15/2020
Last updated
12/29/2021
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