Individual
EDWIN WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 738-6571
(817) 738-6573
Mailing address
PO BOX 1888, GREENVILLE, TX 75403-1888
(800) 945-2455
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E7629
TX
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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