Ian James Johnson
Adolescent Medicine
1381 South Patrick Dr, Patrick Afb 45 Medical Group
Patrick Afb
, Florida 32925-4162
Ian James Johnson
Adolescent Medicine
1381 South Patrick Dr, Patrick Afb 45 Medical Group
Patrick Afb
, Florida 32925-4162
(321) 674-6200
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Ian James Johnson
- 4066 Hield Rd Nw
- Palm Bay, FL
- Zip : 32907-6307
- Fax : (321) 674-6200
- Phone : (321) 674-0932
Second Address
- Ian James Johnson
- 1381 South Patrick Dr, Patrick Afb 45 Medical Group
- Patrick Afb, FL
- Zip : 32925-4162
- Fax : (321) 494-8533
- Phone : (321) 494-8152
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | G0440 | TX |
National Provider Identifier
| NPI | 1265404990 |
|---|---|
| Provider Name | Ian James Johnson |
| First Address | Palm Bay, FL 32907-6307 |
| Second Address | Patrick Afb, FL 32925-4162 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/02/2006 |
| Last Update Date | 25/06/2009 |
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.