Individual
DR. CRAIG M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6535 NEMOURS PARKWAY, NCH, ORLANDO, FL 33282-7884
(407) 567-4000
(407) 567-5924
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 298-7371
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
235491
MA
2085P0229X
Pediatric Radiology Physician
53505
WI
2085P0229X
Pediatric Radiology Physician
C20010119
DE
2085P0229X
Pediatric Radiology Physician
Primary
OS11789
FL
2085R0204X
Vascular & Interventional Radiology Physician
OS11789
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006252800
—
FL
Enumeration date
05/11/2007
Last updated
09/17/2020
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