Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | DO 1167 | AL |
N | 207QA0505X | Family Doctor - Adult Medicine | DO 1167 | AL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | DO 1167 | AL |
NPI | 1205068525 |
---|---|
Provider Name | Dr. Ankrehah Trimble Johnson |
First Address | Birmingham, AL 35235-3400 |
Second Address | Birmingham, AL 35235-3400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2009 |
Last Update Date | 13/06/2013 |