Idella Johnson in Tazewell - Physician Assistant
Idella Johnson - NPI 1073554523
Idella Johnson is a Physician Assistant in Tazewell, Tennessee. Idella Johnson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Idella Johnson is 1073554523. The last update date is 2015-12-16.
Idella Johnson's current location address is 1610 Tazewell Rd, Tazewell, Tennessee. You can contact this provider via phone number 4236268393 and fax number 4236268749. The mailing address for Idella Johnson is 1610 Tazewell Rd, Tazewell, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Idella Johnson |
|---|---|
| Address | 1610 Tazewell Rd, Tazewell, Tennessee |
| Phone Number | 4236268393 |
| Fax Number | 4236268749 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1073554523 |
|---|---|
| Provider Enumeration Date | 2006-06-08 |
| Last Updated Date | 2015-12-16 |
Provider Mailing Address Detail
| Address | 1610 Tazewell Rd |
|---|---|
| City | Tazewell |
| State | Tennessee (TN) |
| Post Code | 378793600 |
| Phone Number | 4236268393 |
| Fax Number | 4236268749 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 670 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3669471 | TN | -- | |
| 4058153 | TN | BCBS OF TENNESSEE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Idella Johnson?
The Idella Johnson has been issued the NPI (National Provider Identifier) 1073554523 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Idella Johnson?
The Idella Johnson is situated at 1610 Tazewell Rd, in the city of Tazewell, state of TN, with the zip code 378793600.
What is Idella Johnson's area of expertise and its corresponding taxonomy classification?
The Idella Johnson's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1073554523 to Idella Johnson?
The Centers for Medicare & Medicaid Services assigned the 1073554523 to Idella Johnson on 2006-06-08.
When was the information related to Idella Johnson most recently updated or refreshed?
The details pertaining to the Idella Johnson, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-12-16.
NPI Number: 1336142389
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