Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 39248 | AL |
NPI | 1023471455 |
---|---|
Provider Name | Erik Richard Johnson |
First Address | Birmingham, AL 35205-4804 |
Second Address | Birmingham, AL 35205-4804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2016 |
Last Update Date | 16/04/2020 |