Individual
JEFFREY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO701
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51004703
BLUE CROSS BLUE SHIELD
AL
01
—
7446374
AETNA
AL
Enumeration date
07/17/2006
Last updated
11/23/2010
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