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Eugene Johnson, IDC

Military Health Care Provider, Independent Duty Corpsman in Jacksonville, FL. Individual provider (NPI-1).

NPI number1447403274
StatusActive
Last updated in NPPESOct 24, 2008

Details

NPI
1447403274
Entity type
Individual (NPI-1)
Name
Mr. Eugene Johnson
Credential
IDC
Sex
Male
Sole proprietor
No
Enumeration date
Oct 24, 2008
Last updated
Oct 24, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1002X Military Health Care Provider, Independent Duty Corpsman––Yes

Other names

  • Eugene Johnson (Other Name)

Practice location

2080 Child St
Naval Air Station
Jacksonville, FL 32214-5005

Phone 904-542-3500 · Fax 904-542-4125

Mailing address

2080 Child St
Naval Air Station
Jacksonville, FL 32214-5005

Phone 904-542-3500 · Fax 904-542-4125

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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