Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 48829 | TN |
N | 207YP0228X | Pediatric Otolaryngology | MD48829 | TN |
NPI | 1821281361 |
---|---|
Provider Name | Benjamin Johnston |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2007 |
Last Update Date | 21/10/2020 |