Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 58136 | TN |
N | 207PP0204X | Pediatric Emergency Physician | 58136 | TN |
NPI | 1134199649 |
---|---|
Provider Name | Dr. Andrew Scott Johnson |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37323-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H29570 | (02) | VA |