Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 62961 | TN |
NPI | 1023547890 |
---|---|
Provider Name | Evan Mccarroll Johnson |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2017 |
Last Update Date | 22/12/2021 |