Dr. Jeremiah J Johnson
Emergency Physician Pediatric Emergency Physician
1100 Wilford Hall Loop
Lackland Afb
, Texas 78236-5638
Dr. Jeremiah J Johnson
Emergency Physician Pediatric Emergency Physician
1100 Wilford Hall Loop
Lackland Afb
, Texas 78236-5638
(210) 292-7331
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About
Features
Specialties
- Emergency Physician
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. Jeremiah J Johnson
- 1100 Wilford Hall Loop
- Lackland Afb, TX
- Zip : 78236-5638
- Phone : (210) 292-7331
Second Address
- Dr. Jeremiah J Johnson
- 1100 Wilford Hall Loop
- Lackland Afb, TX
- Zip : 78236-5638
- Phone : (210) 292-7331
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | N4497 | TX |
| N | 207PP0204X | Pediatric Emergency Physician | N4497 | TX |
National Provider Identifier
| NPI | 1104816362 |
|---|---|
| Provider Name | Dr. Jeremiah J Johnson |
| First Address | Lackland Afb, TX 78236-5638 |
| Second Address | Lackland Afb, TX 78236-5638 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/10/2005 |
| Last Update Date | 12/09/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5907026 | (05) | NC |
| I31301 | (02) | NC |
| N0076G | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.