Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 026668 | CT |
Y | 111NI0900X | Internist | 026668 | CT |
N | 207U00000X | Nuclear Medicine Specialist | 026668 | CT |
NPI | 1598773160 |
---|---|
Provider Name | William David Johns |
First Address | Derby, CT 06418-1328 |
Second Address | West Haven, CT 06516-2770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D80849 | (02) | CT |