Mary Ida Johnson
Child Neurologist
2nd Ambulatory Care Ctr 2211 Lomas Blvd. Ne
Albuquerque
, New Mexico 87131-0001
Mary Ida Johnson
Child Neurologist
2nd Ambulatory Care Ctr 2211 Lomas Blvd. Ne
Albuquerque
, New Mexico 87131-0001
(505) 272-3342
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About
Features
Specialties
- Child Neurologist
Languages spoken
- English
Location
First Address
- Mary Ida Johnson
- 2211 Lomas Blvd Ne Msc10 5620
- Albuquerque, NM
- Zip : 87131-0001
- Phone : (505) 272-3342
Second Address
- Mary Ida Johnson
- 2nd Ambulatory Care Ctr 2211 Lomas Blvd. Ne
- Albuquerque, NM
- Zip : 87131-0001
- Phone : (505) 272-3342
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0402X | Child Neurologist | 2000-214 | NM |
National Provider Identifier
| NPI | 1184630832 |
|---|---|
| Provider Name | Mary Ida Johnson |
| First Address | Albuquerque, NM 87131-0001 |
| Second Address | Albuquerque, NM 87131-0001 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2006 |
| Last Update Date | 08/07/2007 |
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.