Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 50125 | TN |
N | 2081S0010X | Sports Medicine | 44989 | KY |
N | 213ES0000X | Sports Medicine | 44989 | KY |
NPI | 1427220334 |
---|---|
Provider Name | Dr. Joshua Ryan Johnson |
First Address | Knoxville, TN 37909-1293 |
Second Address | Knoxville, TN 37909-1293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 23/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4354821 | BLUECROSS BLUESHIELD (01) | TN |
5203752 | CIGNA (01) | |
P01250957 | RAILROAD MEDICARE (01) | TN |
Q000892 | (05) | TN |