Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME64590 | FL |
NPI | 1013952092 |
---|---|
Provider Name | Dr. Donald Edward Johnson |
First Address | Spring Hill, FL 34608-5045 |
Second Address | Spring Hill, FL 34608-5045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 27/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F74036 | (02) | FL |