| Organization Name: | VANESSA O. JOHNSON,M.D.,PC |
| NPI Number: | 1093967788 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VANESSA O. JOHNSON (PRESIDENT/OWNER) |
| Mailing Address: | 50 Medical Park Boulevard Suite B Petersburg |
| State: | VA US |
| Postal Code: | 23805 |
| Phone Number: | 8047327100 |
| Fax Number: | 8047327101 |
| NPI Enumeration Date: | 10/14/2008 |
| NPI Last Update Date: | 10/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 0101039958 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |