Individual
DR. JASON NATHANIEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
848 ADAMS AVE, L400, MEMPHIS, TN 38103-2816
(919) 684-8111
Mailing address
848 ADAMS AVE, L400, MEMPHIS, TN 38103-2816
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
134548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134548
MEDICAL LISCENSE NUMBER
NC
Enumeration date
05/07/2008
Last updated
08/08/2016
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