| Doctor Name: | RANDY JOHNSON |
| NPI Number: | 1205816105 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | R4A99 |
| Business Practice Address: | 60 Regency Pl Millstadt, IL - 622602210 |
| Business Phone Number: | 6184763373 |
| Business Fax Number: | |
| Mailing Address: | 60 Regency Pl, MILLSTADT |
| State: | IL |
| Postal Code: | 622602210 |
| Phone Number: | 6184763373 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2006 |
| NPI Last Update Date: | 03/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | R4A99 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |