Doctor Name: | WILLIAM H JOHNSON |
NPI Number: | 1992744189 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301026813 |
Business Practice Address: | 16587 Enterprise Dr Three Rivers, MI - 490937902 |
Business Phone Number: | 2692796700 |
Business Fax Number: | 2692799740 |
Mailing Address: | 11451 Coon Hollow Rd, THREE RIVERS |
State: | MI |
Postal Code: | 490939225 |
Phone Number: | 2692796700 |
Fax Number: | 2692799740 |
NPI Enumeration Date: | 06/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301026813 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |